Dental
Dental coverage helps you maintain a healthy smile with preventive care, basic services, and major procedures. You can visit any licensed dentist, but you’ll save the most when you use an in-network provider who has agreed to discounted rates. Out-of-network dentists may charge more than the plan’s allowed amount, and you may be responsible for the difference. Most plans cover preventive services—such as exams, cleanings, and X-rays—at 100% when you stay in-network, making regular checkups an easy way to protect your oral health and avoid costly issues.
DPPO HIGH PLAN
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50 / $150
Annual Plan Max (Individual/Family)
$1,500 per individual
Preventive Care
$0
Basic Services
20%
Major Procedures
50%
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived
Out-of-Network
Deductible (Individual/Family)
$50 / $150
Annual Plan Max (Individual/Family)
$1,500 per individual
Preventive Care
$0
Basic Services
20%
Major Procedures
50%
Orthodontia (Adults and Children)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived
Plan Cost
Employee Only: $9.54
Employee and Spouse: $21.32
Employee and Child(ren): $18.69
Employee and Family: $33.15
DPPO LOW PLAN
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50 / $150
Annual Plan Max (Individual/Family)
$750 per individual
Preventive Care
$0
Basic Services
30%
Major Procedures
Not Covered
Orthodontia (Adults and Children)
Not Covered
Out-of-Network
Deductible (Individual/Family)
$50 / $150
Annual Plan Max (Individual/Family)
$750 per individual
Preventive Care
$0
Basic Services
30%
Major Procedures
Not Covered
Orthodontia (Adults and Children)
Not Covered
Plan Cost
Employee Only: $7.61
Employee and Spouse: $17.14
Employee and Child(ren): $14.75
Employee and Family: $26.62