BASS PRO, INC. / CABELA S

Size: px
Start display at page:

Download "BASS PRO, INC. / CABELA S"

Transcription

1 PPO BASE PLAN - Features BASS PRO, INC. / CABELA S BASE PLAN 2019 PPO Dentist Based on PPO reduced maximum plan allowance Premier Dentist Based on Premiermaximum plan allowance Non-Participating Dentist Based on maximum plan allowance; Balance billing possible Diagnostic and Preventive Services Oral exams (all types), twice per calendar year Bitewing and periapical x-rays as required Full-mouth x-rays once in any 36 consecutive months Prophylaxis (cleanings-all types), twice per calendar year Topical fluoride for dependents to age 19, once per calendar year Emergency palliative treatment Space maintainers for dependents to age 16, once in 5 years 100% 100% 100% Basic Services Sealants for dependents to age 19, once in 5 years Fillings Simple and surgical extractions General anesthesia Endodontics-root canal filling and pulpal therapy Periodontics-treatment for gum disease and bone supporting the teeth Denture repairs and relines 80% 80% 80% Major Services Oral surgery Prosthetics-bridges and dentures; replacements covered once in 5 years, after the participant has been covered by this plan 12 consecutive months Crowns, jackets, labial veneers, inlays and onlays; replacements are covered once in 5 years Calendar Year Deductible (applies to Basic and Major Services only) $50 per person $50 per person $50 per person Calendar Year Maximum $1,000 per person Dependent children are eligible for coverage until they reach age 26. This is intended to be a summary only. If discrepancies arise the Summary Plan Document will govern. Please refer to your SPD for a more complete listing of services including plan limitations and exclusions.

2 PPO ENHANCED PLAN - Features BASS PRO, INC. / CABELA S ENHANCED PLAN 2019 PPO Dentist Based on PPO reduced maximum plan allowance Premier Dentist Based on Premiermaximum plan allowance Non-Participating Dentist Based on maximum plan allowance; Balance billing possible Diagnostic and Preventive Services Oral exams (all types), twice per calendar year Bitewing and periapical x-rays as required Full-mouth x-rays once in any 36 consecutive months Prophylaxis (cleanings-all types), twice per calendar year Topical fluoride for dependents to age 19, once per calendar year Emergency palliative treatment Space maintainers for dependents to age 16, once in 5 years 100% 100% 100% Basic Services Sealants for dependents to age 19, once in 5 years Fillings Simple and surgical extractions General anesthesia Endodontics-root canal filling and pulpal therapy Periodontics-treatment for gum disease and bone supporting the teeth Denture repairs and relines 80% 80% 80% Major Services Oral surgery Prosthetics-bridges and dentures; replacements covered once in 5 years, after the participant has been covered by this plan 12 consecutive months Crowns, jackets, labial veneers, inlays and onlays; replacements are covered once in 5 years Orthodontic Services (for children to under age 19) Calendar Year Deductible (applies to Basic and Major Services only) Calendar Year Maximum Lifetime Orthodontic Maximum $50 per person $50 per person $50 per person $1,500 per person $1,500 per child. Dependent children are eligible for coverage until they reach age 26. This is intended to be a summary only. If discrepancies arise the Summary Plan Document will govern. Please refer to your SPD for a more complete listing of services including plan limitations and exclusions.

3 gives you the freedom to visit the dentist of your choice and to select any dentist on a treatment by treatment basis. It is important to remember your out-of-pocket costs may vary depending on your choice. You have three options and the information below describes what you can expect depending on whether you receive services from a PPO dentist, a Premier dentist or a non-participating dentist. In PPO Network 1. PPO Network* Comprised of a select panel of dentists, over 97,000 dental offices participate in the PPO program. will provide the highest level of benefits (see benefit highlights) for covered services when care is received from a PPO dentist. These dentists agree to: Accept payment based on a reduced fee schedule reducing your out-of-pocket expenses with no balance billing for charges that exceed the fee schedule. Submit dental claims for members and abide by Delta s policies. Charge members only their deductible, co-insurance, and costs for non-covered services at the time of visit because pays the dentist directly. *Your out-of-pocket expenses will be lowest when you see a PPO dentist. In Premier Network 2. Premier Network Comprised of over 174,000 participating dental offices, Premier offers you greater access to dentists while still offering the advantages of a network. These dentists have participating agreements with which require them to: Accept payment based on Delta s contractual agreement which means no balance billing for charges that exceed the contracted amount. Submit dental claims for members and abide by Delta s policies. Charge members only their deductible, co-insurance, and costs for non-covered services at the time of visit because pays the dentist directly. If your dentist is not a PPO dentist but is a Premier dentist, your benefit will be based on the Premier benefit level; however, you will receive the cost control and claims filing advantages noted above. Out of Network 3. Non-participating Dentist If you receive services from a non-participating dentist (does not participate in either network) benefits for covered services are based on the maximum plan allowance and : You will be responsible for filing your own claim forms. s benefit payment will be made directly to you. You will be responsible for the difference between the dentist s charge and the maximum plan allowance. Your out-of-pocket expenses may be more when you use a non-participating dentist. Locating a Participating Dentist To determine if your dentist participates with or to select a participating dentist in your area: Ask your dentist if he or she participates in the PPO or Premier program Search on-line at Call Customer Service at Or Scan the image below to search for a PPO or Premier participating dentist:

4 TO SAVE THE MOST MONEY: SEE A DELTA DENTAL PPO SM NETWORK DENTIST Dentists can participate with of Missouri through two networks: PPO SM network or Premier network. Be sure to ask your dentist, WHICH network are you in? Here s why: COST SAVINGS EXAMPLE (ASSUMES YOUR DEDUCTIBLE HAS BEEN PAID AND SHOWS APPLICABLE COINSURANCE PERCENT) SAVE THE MOST WITH A DELTA DENTAL PPO SM DENTIST allows: $300 PPO dentist accepts: $300 SAVE MONEY WITH A DELTA DENTAL PREMIER DENTIST allows: $420 Premier dentist accepts: $420 PAY MORE WITH AN OUT-OF-NETWORK DENTIST (O-O-N) allows: $300 O-O-N dentist accepts: $500 Your plan pays 80% of $300: $240 YOU PAY 20% of $300 (20% x $300): $60 Your plan pays 80% of $420: $336 YOU PAY 20% of $420: $84 Your plan pays 80% of $300: $240 YOU PAY 20% of $300: $60 Plus, you pay the difference: $200 TOTAL YOU PAY: $60 TOTAL YOU PAY: $84 TOTAL YOU PAY: $260 SAVE THE MOST MONEY WHEN YOU SEE A DELTA DENTAL PPO SM NETWORK DENTIST - Before you visit your dentist, ask if he or she is in the PPO SM Network. - Your coinsurance costs are calculated on a lesser amount. - You will pay less out of your pocket at a PPO dentist. - Your benefits dollars stretch farther. SAVE MONEY WHEN YOU SEE A DENTAL PREMIER NETWORK DENTIST - When you visit a dentist in the Premier Network, you still enjoy valuable savings. PAY MORE WITH AN OUT-OF-NETWORK DENTIST - When your dentist is not in a network, you will pay more. - You may have to pay your dentist up front, file your own claim and receive payment from. To find a dentist in the PPO SM network or Premier network, go to:

5 24/7 Online Access to Benefits and Service Review and print your dental plan s coverage levels, deductibles, maximums, age limits and limitations Verify your eligibility Request or download a claim form Find a provider Order or print an ID card Download our mobile app Get answers to frequently asked questions Register Today Visit to receive electronic delivery of your benefit information Log In to View Your Benefits Just visit and click on one of the Member or Sign In links. To register, follow the steps under Member Sign In. Find a Participating Dentist Visit our website, and click on Find a Provider then on Find a Dentist. Customer Service Call: We are here to help you every Monday through Friday from 7 a.m. to 5 p.m. Central Time. Mobile App Your dental health is important to and to your overall health! We ve designed our mobile app to make it easy for you to make the most of your dental benefits. Maximize your health, wherever you are! Access dentist search, check claims and coverage, view ID cards and more, right on your mobile device. Mobile ID card - no more looking for ID cards! Claims and coverage information on the go, putting benefits information right at your fingertips. A dentist search tool that helps you quickly select an in-network provider nearby, and even book an appointment with participating dentists! Our toothbrush timer motivates you to brush for the recommended two minutes. DDMO

Lincoln County School District

Lincoln County School District Lincoln County School District Delta Dental will be your new dental benefits provider effective July 1, 2016. Delta Dental has two networks of participating providers: Delta PPO & Delta Premier. Please

More information

Your Dental Benefits. The Local Choice Dental Benefits Program

Your Dental Benefits. The Local Choice Dental Benefits Program Your Dental Benefits The Local Choice Dental Benefits Program WELCOME to Delta Dental of Virginia In addition to the largest network of dentists in Virginia* and valuable benefits that help keep out-of-pocket

More information

2014 Rates. About Delta Dental networks BENEFITS OVERVIEW. Employee Only: $ Employee & Spouse: $ Employee & Child(ren): $83.

2014 Rates. About Delta Dental networks BENEFITS OVERVIEW. Employee Only: $ Employee & Spouse: $ Employee & Child(ren): $83. BENEFITS OVERVIEW Benefit Summary for: Denny s, Inc. Effective Date: January 1, 2014 Plan Option: HIGH PLAN Delta Dental PPO Dentacare M Delta Dental PPO & Premier Non- Participating Providers Part-Time

More information

Your Dental Benefits The Local Choice. Retiree Health Benefits Program for Medicare-Eligible Retirees

Your Dental Benefits The Local Choice. Retiree Health Benefits Program for Medicare-Eligible Retirees Your Dental Benefits The Local Choice Retiree Health Benefits Program for Medicare-Eligible Retirees Welcome to Delta Dental of Virginia In addition to the largest network of dentists in the nation* and

More information

Your Dental Benefits. The Local Choice Dental Benefits Program

Your Dental Benefits. The Local Choice Dental Benefits Program Your Dental Benefits The Local Choice Dental Benefits Program Welcome to Delta Dental of Virginia In addition to the largest network of dentists in Virginia* and valuable benefits that help keep your out-of-pocket

More information

Your Delta Dental Program

Your Delta Dental Program Good oral health starts with knowledge. Smart plans for smart mouths. Your Delta Dental Program With your dental benefit program, you are free to go to any licensed dentist. However, you will save the

More information

Dental Benefit Summary

Dental Benefit Summary TriNet Group Number: 00499262 Dental Benefit Summary About Your Benefits: A visit to your dentist can help you keep a great smile and prevent many health issues. But dental care can be costly and you can

More information

Baltimore City Public Schools 2013 Dental Options

Baltimore City Public Schools 2013 Dental Options Baltimore City Public Schools 2013 Dental Options Baltimore City Public Schools Important Phone Numbers for 2013 DHMO Customer Service (410) 847-9060 or (888) 833-8464 DHMO Mailing Address The Dental Network

More information

Why do you need a dental plan?

Why do you need a dental plan? Prepared for Comal County Guardian Group Plan Number 00406388 Why do you need a dental plan? 1 SAVE MONEY The average family spends $1353 each year on dental services, and twice that if children need braces.

More information

2017 Dental Options BALTIMORE CITY PUBLIC SCHOOLS. Baltimore City Public Schools 2017 Dental Options C1

2017 Dental Options BALTIMORE CITY PUBLIC SCHOOLS. Baltimore City Public Schools 2017 Dental Options C1 2017 Dental Options BALTIMORE CITY PUBLIC SCHOOLS Baltimore City Public Schools 2017 Dental Options C1 Table of Contents Important Information for 2017... 1 Dental HMO (DHMO)... 2 Preferred Dental PPO

More information

Keep Smiling Delta Dental PPO SM

Keep Smiling Delta Dental PPO SM Keep Smiling Delta Dental PPO SM Save with PPO Visit a dentist in the PPO 1 network to maximize your savings. 2 These dentists have agreed to reduced fees, and you won t get charged more than your expected

More information

State of New Mexico Group Dental Benefits Plan

State of New Mexico Group Dental Benefits Plan State of New Mexico Group Dental Benefits Plan Administered by Delta Dental of New Mexico Plan Year: January 1 December 31, 2018 Dental Networks Overview PPONew Mexico Delta Dental PPO Find a Dentist In

More information

DENTAL PLAN INFORMATION

DENTAL PLAN INFORMATION County of Kern DENTAL PLAN INFORMATION FOR PERMANENT EMPLOYEES Independence PPO Dental LIBERTY Cobalt Plus DHMO Dental Administered by LIBERTY Dental Plan of California 1(888) 273-3179 www.libertydentalplan.com/countyofkern

More information

HealthPartners State of Minnesota Dental Plan Appendix

HealthPartners State of Minnesota Dental Plan Appendix HealthPartners State of Minnesota Dental Plan Appendix Effective Date: The later of the effective date of your Employer s Dental Benefit Plan or your effective date of coverage under the Plan. See Section

More information

Open/Switch Enrollment 2017

Open/Switch Enrollment 2017 State of New Mexico Group Benefits Plan Administered by Delta Dental of New Mexico Open/Switch Enrollment 2017 Plan Year: January 1 December 31, 2017 Dental Networks Overview PPONew Mexico Delta Dental

More information

Open/Switch Enrollment 2015

Open/Switch Enrollment 2015 State of NM Group Benefits Plan Plan Year Jan-Dec 2015 Administered by of New Mexico Open/Switch Enrollment 2015 The State of NM Group Benefits Dental Plan Provider Network PPONew Mexico (In-Network New

More information

(For Customer Service and Benefit Information) (314) (800) Summary Plan Description (SPD)

(For Customer Service and Benefit Information) (314) (800) Summary Plan Description (SPD) Summary Plan Description (SPD) (For Customer Service and Benefit Information) (314) 656-3001 (800) 335-8266 www.deltadentalmo.com ASPD-PPO-DMDFD4-8 Delta Dental of Missouri PO Box 8690, St. Louis, MO 63126-0690

More information

Dental POS Benefit Summary

Dental POS Benefit Summary Dental POS Benefit Summary PFG HC Dental 13 Predetermination of Benefits: Before treatment begins for inlays, onlays, single crowns, prosthetics, periodontics and oral surgery, you may file a dental treatment

More information

Welcome to Arkansas Blue Cross and Blue Shield Dental Plan

Welcome to Arkansas Blue Cross and Blue Shield Dental Plan Welcome to Arkansas Blue Cross and Blue Shield Dental Plan University of Arkansas System Dental Program Beginning January 1, 2018, the University of Arkansas System dental plan will be administered by

More information

III. Dental Program Table of Contents

III. Dental Program Table of Contents III. Dental Program Table of Contents About This Section...1 An Overview of Your Dental Program Options...2 Delta Dental...3 Preventive/Diagnostic Care...3 Basic Restorative Care...3 Major Restorative

More information

2017 FAQs. Dental Plan. Frequently Asked Questions from employees

2017 FAQs. Dental Plan. Frequently Asked Questions from employees 2017 FAQs Dental Plan Frequently Asked Questions from employees September 2016 Dental plan Questions we ve heard our employees ask Here are some commonly asked questions about the Dental plan that our

More information

Brevard Public Schools

Brevard Public Schools Brevard Public Schools Your Delta Dental Benefits Plan Delta Dental PPO High & Low Option Plan Highlights Diagnostic & Preventive Maximum Waiver Benefit Missing Teeth Covered Composite Fillings Covered

More information

New Mexico Retiree Health Care Authority Dental Plans. Delta Dental of New Mexico. Effective Date: January 1, 2018

New Mexico Retiree Health Care Authority Dental Plans. Delta Dental of New Mexico. Effective Date: January 1, 2018 New Mexico Retiree Health Care Authority Dental Plans Delta Dental of New Mexico Effective Date: January 1, 2018 Reminder-Choose Between Two Plans Basic Plan Covers: Preventive Services (such as evaluations

More information

DELTA DENTAL OF OKLAHOMA

DELTA DENTAL OF OKLAHOMA DELTA DENTAL OF OKLAHOMA STATE, EDUCATION & LOCAL GOVERNMENT EMPLOYEES DENTAL BENEFITS OPTIONS 2019 OUR STANDARD IS TO EXCEED YOUR EXPECTATIONS WE DELIVER A SUPERIOR CUSTOMER EXPERIENCE DDOK DOES NOT DENY

More information

For all eligible employees of Louisiana Riverboat Gaming Partnership dba Diamond Jacks Casino - Bossier City, Policy # All Eligible Employees

For all eligible employees of Louisiana Riverboat Gaming Partnership dba Diamond Jacks Casino - Bossier City, Policy # All Eligible Employees Dental insurance Benefit Highlights For all eligible employees of Louisiana Riverboat Gaming Partnership dba Diamond Jacks Casino - Bossier City, Policy # 902360 All Eligible Employees Effective date:

More information

Deductible 3 Individual $50 $50. Annual Maximum Benefit: Per Individual $2,000 $2,000

Deductible 3 Individual $50 $50. Annual Maximum Benefit: Per Individual $2,000 $2,000 Dental Plan Design for: Ector County Independent School District Original Plan Effective Date: January 1, 2018 Network: PDP Plus The Preferred Dentist Program was designed to help you get the dental care

More information

University of Arkansas System

University of Arkansas System University of Arkansas System Dental Plan 2018 Welcome University of Arkansas System employees! Beginning January 1, 2018, the University of Arkansas System (UAS) dental plan will be administered by Arkansas

More information

Voluntary Dental. Tiered Approach. An independent licensee of the Blue Cross and Blue Shield Association. 28XX1361 R04/07

Voluntary Dental. Tiered Approach. An independent licensee of the Blue Cross and Blue Shield Association. 28XX1361 R04/07 Voluntary Dental Tiered Approach An independent licensee of the Blue Cross and Blue Shield Association. Affordable protection for employees and their families 28XX1361 R04/07 Direct to You...Voluntary

More information

Individual Dental Insurance Plans & Delta Dental Patient Direct

Individual Dental Insurance Plans & Delta Dental Patient Direct 20 13 Individual Dental Insurance Plans & Delta Dental Patient Direct Our dental insurance and discount card programs offer Illinois individuals, couples and families without an employer-sponsored dental

More information

THE CALIFORNIA STATE UNIVERSITY DENTAL PROGRAM OVERVIEW

THE CALIFORNIA STATE UNIVERSITY DENTAL PROGRAM OVERVIEW THE CALIFORNIA STATE UNIVERSITY DENTAL PROGRAM OVERVIEW Plan Year: January 1, 2019 December 31, 2019 The California State University Dental Program consists of two types of plans: Delta Dental PPO and.

More information

Dental Blue Program 2

Dental Blue Program 2 SUMMARY OF BENEFITS Dental Blue Program 2 (with Orthodontics) Medium Option Massachusetts Bankers Association Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue

More information

BENEFIT OUTLINE. For COUNTY OF ONONDAGA ONONDAGA COUNTY DENTAL BENEFITS PLAN. Dental Claims Administration By EFFECTIVE: JANUARY 1, 2010

BENEFIT OUTLINE. For COUNTY OF ONONDAGA ONONDAGA COUNTY DENTAL BENEFITS PLAN. Dental Claims Administration By EFFECTIVE: JANUARY 1, 2010 BENEFIT OUTLINE For COUNTY OF ONONDAGA ONONDAGA COUNTY DENTAL BENEFITS PLAN Dental Claims Administration By EFFECTIVE: JANUARY 1, 2010 This benefit outline is not a Summary Plan Description and should

More information

Dental Options 2018 BALTIMORE CITY PUBLIC SCHOOLS

Dental Options 2018 BALTIMORE CITY PUBLIC SCHOOLS Dental Options 2018 BALTIMORE CITY PUBLIC SCHOOLS Contents Important Information for 2018... 1 Dental HMO (DHMO) Dental Plan... 2 Preferred Dental PPO (DPPO) Dental Plan... 3 Summary of Dental PPO Benefits...

More information

Dental EPO Benefit Summary

Dental EPO Benefit Summary Dental EPO Benefit Summary PFG HC Dental 12 Predetermination of Benefits: Before treatment begins for inlays, onlays, single crowns, prosthetics, periodontics and oral surgery, you may file a dental treatment

More information

Choosing your plan. City of Sacramento. We ll do whatever it takes and then some. Your Two Delta Dental Plan Options

Choosing your plan. City of Sacramento. We ll do whatever it takes and then some. Your Two Delta Dental Plan Options City of Sacramento Choosing your plan Your Two Delta Dental Plan Options The choice is yours. When it comes to dental health, you want benefits that provide you with the best balance of value and coverage.

More information

HealthPartners Dental Distinctions Benefits Chart

HealthPartners Dental Distinctions Benefits Chart HealthPartners Dental Distinctions Benefits Chart Effective Date: The later of the effective date, or most recent anniversary date, of the Master Group Contract and your effective date of coverage under

More information

Dental POS Benefit Summary

Dental POS Benefit Summary Policyholder: UC Postdoctoral Scholar Dental POS Benefit Summary Effective date: 01/01/2019 This chart provides you a brief summary of the key benefits of the dental coverage available from Principal Life

More information

Dental Benefit Summary MetLife Preferred Dentist Program (PDP)

Dental Benefit Summary MetLife Preferred Dentist Program (PDP) Dental Benefit Summary MetLife Preferred Dentist Program (PDP) CORE and BUY-UP Dental Options Note: MetLife Dental Plans require that any dental election, including declining coverage, can only be changed

More information

Dental Blue Program 2. Summary of Benefits. Amherst College

Dental Blue Program 2. Summary of Benefits. Amherst College Dental Blue Program 2 Summary of Benefits Amherst College Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Dental Blue Program 2 Preventive

More information

Step by Step: How to maximize your benefits

Step by Step: How to maximize your benefits Step by Step: How to maximize your benefits Learn how to access your ID card, search for a dentist near you, download the Delta Dental mobile app and more! Click on a topic below to learn more: Subscriber

More information

Good news about dental benefits for employees of. LCMC Health

Good news about dental benefits for employees of. LCMC Health Dental PPO Good news about dental benefits for employees of LCMC Health Why is dental health so important? Regular dental care does more than just improve smiles. Along with good oral hygiene, it can help

More information

Delta Dental of Illinois Individual and Family Dental Benefits and Discount Programs

Delta Dental of Illinois Individual and Family Dental Benefits and Discount Programs Delta Dental of Illinois Individual and Family Dental Benefits and Discount Programs Our dental benefit and discount card programs offer Illinois individuals, couples and families access to affordable

More information

WESTERN MICHIGAN UNIVERSITY Group# /0048 Dental Coverage Effective Date: On or after January 2018 Benefits-at-a-glance

WESTERN MICHIGAN UNIVERSITY Group# /0048 Dental Coverage Effective Date: On or after January 2018 Benefits-at-a-glance WESTERN MICHIGAN UNIVERSITY Group# 007005281/0048 Dental Effective Date: On or after January 2018 -at-a-glance This is intended as an easy-to-read summary and provides only a general overview of your benefits.

More information

Premera DentalBlueTM FOR ALASKA GROUPS WITH 2+ EMPLOYEES

Premera DentalBlueTM FOR ALASKA GROUPS WITH 2+ EMPLOYEES Premera DentalBlueTM FOR ALASKA GROUPS WITH 2+ EMPLOYEES January 2015 Dental product options that let you build a comprehensive benefits package Premera Blue Cross Blue Shield of Alaska offers a range

More information

Your Guide to Healthy Smiles: Supplemental Dental Benefits

Your Guide to Healthy Smiles: Supplemental Dental Benefits If you currently have supplemental dental coverage, you will need to enroll in a new plan during the It s Your Choice enrollment period to have coverage in 2019. See page 7 for more information. Your Guide

More information

EUTF and HSTA VB Retirees Group Number 2601 Dental Plan Benefits

EUTF and HSTA VB Retirees Group Number 2601 Dental Plan Benefits EUTF and HSTA VB Retirees Group Number 2601 Dental Plan Benefits A lifetime of healthy smiles for Hawai i families This brochure includes a brief description of your HDS dental benefits. All benefits are

More information

Anthem Blue Dental PPO Voluntary Option 2V Summary of Benefits

Anthem Blue Dental PPO Voluntary Option 2V Summary of Benefits Anthem Blue Dental PPO Voluntary Option 2V Summary of Benefits Annual Benefit Limit: $1500 Annual Member Deductible: $50 PPO Dentist $50 Non-PPO Dentist Family Coverage Deductible Limit 3 times Annual

More information

THE CALIFORNIA STATE UNIVERSITY DENTAL PROGRAM OVERVIEW Plan Year: January 1, 2016 December 31, 2016

THE CALIFORNIA STATE UNIVERSITY DENTAL PROGRAM OVERVIEW Plan Year: January 1, 2016 December 31, 2016 THE CALIFORNIA STATE UNIVERSITY DENTAL PROGRAM OVERVIEW Plan Year: January 1, 2016 December 31, 2016 The California State University Dental Program consists of two types of plans: Delta Dental PPO and

More information

Retiree Dental Open Enrollment

Retiree Dental Open Enrollment Retiree Dental Open Enrollment November 1 December 15, 2017 Open Enrollment Fact Sheet Delta Dental Information Sheet Delta Dental Enrollment Form Delta Dental Direct Debit Application Retiree Dental Plan

More information

Dental Benefits Options For State, Education & Local Government Employees

Dental Benefits Options For State, Education & Local Government Employees 2016 2017 Dental Benefits Options For State, Education & Local Government Employees Option 1: Delta Dental PPO* Benefit Plan Delta Dental PPO Network Delta Dental Premier Network OR Non-Participating Dentist

More information

THE CALIFORNIA STATE UNIVERSITY DENTAL PROGRAM OVERVIEW Plan Year: January 1, 2017 December 31, 2017

THE CALIFORNIA STATE UNIVERSITY DENTAL PROGRAM OVERVIEW Plan Year: January 1, 2017 December 31, 2017 THE CALIFORNIA STATE UNIVERSITY DENTAL PROGRAM OVERVIEW Plan Year: January 1, 2017 December 31, 2017 The California State University Dental Program consists of two types of plans: Delta Dental PPO and

More information

Dental Coverage. Click here to download and print this entire section.

Dental Coverage. Click here to download and print this entire section. Dental Coverage Click here to download and print this entire section. Good dental habits are an important part of safeguarding your general health. They also help you reduce dental bills. The dental coverage

More information

Healthy You. Healthy Mouth = Great health starts with your mouth.

Healthy You. Healthy Mouth = Great health starts with your mouth. Healthy Mouth = Healthy You Great health starts with your mouth. Learn how using your ExxonMobil dental benefits helps contribute to a healthier you! Your overall health starts at the top Your mouth is

More information

Dental insurance is important. It s a fact.

Dental insurance is important. It s a fact. Dental insurance is important. It s a fact. www.deltadentalco.com Fact: Your health could be at risk. Yes, it s true. Your overall health may be impacted by your oral health. Researchers have uncovered

More information

PLAN OPTION 1. Network Select Plan. Out-of-Network % of R&C Fee **

PLAN OPTION 1. Network Select Plan. Out-of-Network % of R&C Fee ** Harvest Management Sub LLC. dba Holiday Retirement Dental Metropolitan Life Insurance Company Network: PDP Coverage Type Type A: Preventive (cleanings, exams, X-rays) Type B: Basic (fillings, extractions)

More information

COVERED DELTA DENTAL PPO YOUR SMILE IS SAVE WITH A PPO DENTIST NON-DELTA

COVERED DELTA DENTAL PPO YOUR SMILE IS SAVE WITH A PPO DENTIST NON-DELTA DELTA DENTAL PPO : YOUR SMILE IS COVERED GO PPO! You can visit any licensed dentist under this plan, but you ll maximize plan value by selecting a Delta Dental PPO 1 dentist. PPO network dentists have

More information

Your Smile, Your Choice

Your Smile, Your Choice Your Smile, Your Choice Delta Dental PPO SM & DeltaCare USA Your company lets you choose between two dental plans from Delta Dental. Either way, you ll get reliable dentist networks and affordable preventive

More information

Delta Dental of Illinois Individual and Family Dental Benefit Program

Delta Dental of Illinois Individual and Family Dental Benefit Program Delta Dental of Illinois Individual and Family Dental Benefit Program Smart plans for smart mouths. Off-exchange Protect your smile. Protect your budget. That s smart. Our individual and family dental

More information

Choice, Service, Savings. To help you enroll, the following pages outline your company's dental plan and address any questions you may have.

Choice, Service, Savings. To help you enroll, the following pages outline your company's dental plan and address any questions you may have. Dental Plan Design for: San Jose Convention & Visitors Bureau Effective Date: March 1, 2000 Amendment Effective Date ± : November 1, 2017 Date Prepared: January 4, 2018 Choice, Service, Savings. To help

More information

A DENTAL PLAN THAT BALANCES CHOICE & SAVINGS

A DENTAL PLAN THAT BALANCES CHOICE & SAVINGS A DENTAL PLAN THAT BALANCES CHOICE & SAVINGS GuideStone s Choice Dental Plan with the Total Cigna DPPO Network The Total Cigna Dental PPO (DPPO) network makes it easy to help protect your health and your

More information

III. Dental Program Table of Contents

III. Dental Program Table of Contents III. Dental Program Table of Contents About This Section...1 An Overview of Your Dental Program Options...2 MetLife and Delta Dental Options...2 Preventive/Diagnostic Care...3 Basic Restorative Care...3

More information

Dental. Ingredion Corporation. Network: PDP. In-Network. Out-of-Network. Coverage Type. Metropolitan Life Insurance Company

Dental. Ingredion Corporation. Network: PDP. In-Network. Out-of-Network. Coverage Type. Metropolitan Life Insurance Company Ingredion Corporation Dental Metropolitan Life Insurance Company Network: PDP Coverage Type Type A: Preventive (cleanings, exams, X-rays) Type B: Basic Restorative (fillings, extractions) Type C: Major

More information

dental and vision plans

dental and vision plans dental and vision plans for AVMA LIFE members and their staff Administered by Delta Dental of Illinois A dental and vision plan is a great way to support your oral and eye health, as well as your overall

More information

Dental Insurance Plans

Dental Insurance Plans Dental Insurance Plans Mid-Tex Educators Benefits Coopera ve Why is dental health so important? Regular dental care does more than just improve smiles. Along with good oral hygiene, it can help you and

More information

A DENTAL PLAN THAT BALANCES CHOICE & SAVINGS

A DENTAL PLAN THAT BALANCES CHOICE & SAVINGS A DENTAL PLAN THAT BALANCES CHOICE & SAVINGS GuideStone s Choice Dental Plan Cigna Total DPPO The Cigna Total Dental PPO (DPPO) network makes it easy to protect your health and your smile with the right

More information

The Standard (Ameritas) Dental Insurance

The Standard (Ameritas) Dental Insurance The Standard (Ameritas) Dental Insurance Dental Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of treatment and routine care, dental disease and

More information

2009 Summary of Covered Dental Services

2009 Summary of Covered Dental Services 2009 Summary of Covered Dental Services 2009 Summary of Covered Dental Services This summary shows the coverage details for the dental options offered by Xerox. It is not an all-inclusive summary of plan

More information

DELTA DENTAL PPO SUMMARY OF BENEFITS FOR COVERED EMPLOYEES OF: County of Dane. (See Dental Benefit Handbook for definitions of capitalized terms.

DELTA DENTAL PPO SUMMARY OF BENEFITS FOR COVERED EMPLOYEES OF: County of Dane. (See Dental Benefit Handbook for definitions of capitalized terms. DELTA DENTAL PPO SUMMARY OF BENEFITS FOR COVERED EMPLOYEES OF: County of Dane (See Dental Benefit Handbook for definitions of capitalized terms.) GROUP NUMBER: 00704-00000 EFFECTIVE DATE OF PROGRAM: January

More information

Five Colleges, Inc. ~ Memorandum

Five Colleges, Inc. ~ Memorandum Five Colleges, Inc. ~ Memorandum To: All Benefited s From: Barbara Lucey Date: October, 2017 Re: Health and Dental Insurance Health Plan Good news, we are staying with Harvard Pilgrim this year for both

More information

Plans. Members choose what they Value Most

Plans. Members choose what they Value Most FLE x Plans Members choose what they Value Most FLE x Plans Members choose what they value most; better coverage or more provider choice Renaissance Dental Your Partner in Success! As a leading dental

More information

Smile: Let the individual in you shine with a dental plan. from the most trusted name in dental benefits. Individual Dental Insurance

Smile: Let the individual in you shine with a dental plan. from the most trusted name in dental benefits. Individual Dental Insurance Smile: Let the individual in you shine with a dental plan from the most trusted name in dental benefits Individual Dental Insurance Individual dental insurance keeps you and your smile healthy! Why is

More information

Re: Health and Dental Insurance

Re: Health and Dental Insurance Five Colleges, Inc. ~ Memorandum To: All Benefited s From: Barbara Lucey Date: November, 2017 Re: Health and Dental Insurance We are staying with Harvard Pilgrim as our health insurance carrier this year.

More information

Federal Employee Dental Options Guide for Lovelace FEHB Plan Members

Federal Employee Dental Options Guide for Lovelace FEHB Plan Members Federal Employee Dental Options 2014 Guide for Lovelace FEHB Plan Members Option 1: Sandia Plan The Sandia Plan is the most economic dental plan option. Members obtain dental services from our ever expanding

More information

Dental Plans for All Employers

Dental Plans for All Employers Delta Dental of Nebraska 2018 Plans: Delta Dental PPO plus Premier - Dental Access Delta Dental PPO plus Premier - Millennium Choice Delta Dental PPO plus Premier - Dental Flex Delta Dental PPO plus Premier

More information

Affordable dental plan and package options for Medicare Supplement plan members

Affordable dental plan and package options for Medicare Supplement plan members Last updated: December 2017 Affordable dental plan and package options for Medicare Supplement plan members Blue Shield of California rates effective: April 1, 2018 blueshieldca.com Something to smile

More information

Your Dental and Vision Benefits Beaver Motors

Your Dental and Vision Benefits Beaver Motors OPEN ENROLLMENT 2017 Summary of Benefits Your Dental and Vision Benefits Beaver Motors Relationships are built on trust. Respect for an individual s privacy goes a long way toward building trust. Humana

More information

MetLife Dental Insurance Plan Summary. In-Network % of Negotiated Fee * % of R&C Fee 100% 100% 80% 80% 50% 50%

MetLife Dental Insurance Plan Summary. In-Network % of Negotiated Fee * % of R&C Fee 100% 100% 80% 80% 50% 50% TriNet IV, Inc. Classic Option LA, MS, MT& TX Employees Network: PDP Plus Coverage Type Type A: Preventive (cleanings, exams, X-rays) Type B: Basic Restorative (fillings, extractions) Type C: Major Restorative

More information

Dental Schedule. Handbook

Dental Schedule. Handbook Your guide to the Alberta Blue Cross Dental Schedule 2017 Dental Schedule Handbook Alberta Blue Cross Dental Schedule: 2017 Helping you keep your healthy smile January 2017 1 2 3 4 5 6 7 8 9 10 11 12 13

More information

The Standard (Ameritas) Dental Insurance

The Standard (Ameritas) Dental Insurance The Standard (Ameritas) Dental Insurance Dental Dental insurance is a coverage that helps defray the costs of dental care. It insures against the expense of treatment and routine care, dental disease and

More information

(with Orthodontics) Summary of Benefits

(with Orthodontics) Summary of Benefits Dental Blue Program 2 (with Orthodontics) Summary of Benefits Amherst College Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association Dental Blue

More information

Delta Dental Web Site

Delta Dental Web Site Delta Dental Web Site You can find helpful information about your Delta Dental benefits plan 24 hours a day, 7 days a week at www.consumertoolkit.com. Find A Provider (Quickly and Easily!) Create a customized

More information

Creighton University s Enhanced Dental Plan Benefits

Creighton University s Enhanced Dental Plan Benefits Creighton University s Enhanced Dental Plan Benefits For the savings you need, the flexibility you want and service you can trust. Benefit Summary Coverage Type PDP In-Network: Out-of-Network: Type A cleanings,

More information

PLAN OPTION 1 Low Plan Employees (30 hours) Out-of-Network % of Negotiated Fee*

PLAN OPTION 1 Low Plan Employees (30 hours) Out-of-Network % of Negotiated Fee* Green Dot Public Schools MetLife Dental Insurance Plan Summary Network: PDP PLAN OPTION 1 Low Plan Employees (30 hours) PLAN OPTION 2 High Plan Employees (30 hours) Coverage Type In-Network Fee * Out-of-Network

More information

Anthem.+I. BlueCroi BluoSWrld T. V,

Anthem.+I. BlueCroi BluoSWrld T. V, Page 1 of 5 Anthem.+I BlueCroi BluoSWrld T. V, Employer/Group: LEDYARD: TOWN AND BOARD OF EDUCATION Firm Division: 002088224 - LEDYARD BOARD OF ED FULL DENTAL,ABCD The Full Dental Plan covers diagnostic,

More information

MetLife Dental Insurance Plan Summary

MetLife Dental Insurance Plan Summary Public School Retirement System of the City of St Louis For MS and TX residents MetLife Dental Insurance Plan Summary Network: PDP Plus Coverage Type Type A: Preventive (cleanings, exams) Type B: Basic

More information

UNION. Dental plan. Mail Handlers Local 323 Dental Program. Extra support

UNION. Dental plan. Mail Handlers Local 323 Dental Program. Extra support 2017 D ota Minn e North ak ta so UNION Dental plan 3 Extra support 7 Mail Handlers Local 323 Dental Program 2 You lie back in the dentist s chair, mouth open wide and wonder what exactly is your dentist

More information

DanJack Enterprises, Inc., d/b/a Business Resource Services (BRS) FUSION Highlight Sheet

DanJack Enterprises, Inc., d/b/a Business Resource Services (BRS) FUSION Highlight Sheet Plan 1 Effective Date: 1/1/2019 FUSION: THE ULTIMATE CHOICE SM combines dental and eye care benefits in one easy-to-administer plan. This plan combines the annual maximum between the dental and eye care

More information

Dental Insurance. State of Florida Dental Benefit for the State Group Insurance Program

Dental Insurance. State of Florida Dental Benefit for the State Group Insurance Program Dental Insurance State of Florida Dental Benefit for the State Group Insurance Program Welcome! Why is having a good Dental plan so important? Because a healthier smile can be important to maintaining

More information

2018 Presbyterian Health Plan Federal Employee Dental & Vision Options

2018 Presbyterian Health Plan Federal Employee Dental & Vision Options 2018 Presbyterian Health Plan Federal Employee Dental & Vision Options For more information: 1804 Juan Tabo NE, Suite A, Albuquerque, NM 87112 888 862 8659 505 237 1501 benefitsource.org These benefits

More information

Exclusive Panel Option (EPO 1-B) a feature of the Delta Dental PPO Denver Public Schools- Group #

Exclusive Panel Option (EPO 1-B) a feature of the Delta Dental PPO Denver Public Schools- Group # Exclusive Panel Option (EPO 1-B) a feature of the Delta Dental PPO Denver Public Schools- Group #6694 7.2011 MAXIMUM BENEFIT Calendar Year Orthodontic Lifetime CALENDAR YEAR DEDUCTIBLE WHO CAN BE COVERED

More information

Voluntary Dental PPO (Indemnity Plan)

Voluntary Dental PPO (Indemnity Plan) Voluntary Dental PPO (Indemnity Plan) Good news about your dental benefits Your Dental Plan As a valued employee of Cypress-Fairbanks ISD, you have the opportunity to enroll in a payroll-deduction dental

More information

Anthem Extras Packages

Anthem Extras Packages Anthem Extras Packages Dental, Vision and more California Benefits that complement your Medicare Supplement plan Packaged benefits better together Healthy teeth and eyes help contribute to your overall

More information

Affordable dental plan and package options for Medicare Supplement plan members

Affordable dental plan and package options for Medicare Supplement plan members Last updated: January 2019 Affordable dental plan and package options for Medicare Supplement plan members Blue Shield of California rates effective: April 1, 2018 blueshieldca.com Something to smile about

More information

Delta Dental PPO Plan Benefit Summary

Delta Dental PPO Plan Benefit Summary Delta Dental PPO Plan Benefit Summary SAIF Corporation Group ID: 10001747 Effective: January 1, 2018 Calendar year costs Annual Maximum, per member Calendar year deductible, per member Calendar year maximum

More information

PLAN OPTION 1 High Plan. Out-of-Network % of R&C Fee ** % of Negotiated

PLAN OPTION 1 High Plan. Out-of-Network % of R&C Fee ** % of Negotiated Clearway Energy Group LLC Dental Metropolitan Life Insurance Company Network: PDP Plus Coverage Type In-Network % of Negotiated Fee * PLAN OPTION 1 High Plan In-Network Out-of-Network % of R&C Fee ** %

More information

PLAN OPTION 1 Plus Plan. Out-of-Network % of R&C Fee ** % of Negotiated

PLAN OPTION 1 Plus Plan. Out-of-Network % of R&C Fee ** % of Negotiated Metropolitan Life Insurance Company Network: PDP Plus Coverage Type In-Network % of Negotiated Fee * PLAN OPTION 1 Plus Plan In-Network Out-of-Network % of R&C Fee ** % of Negotiated Fee * PLAN OPTION

More information

Dental Program. Insurance meets assurance. Mail Handlers Local OPEN ENROLLMENT A HEALTH PLAN TO BE SURE ABOUT DENTAL PLAN 3 EXTRA SUPPORT 9

Dental Program. Insurance meets assurance. Mail Handlers Local OPEN ENROLLMENT A HEALTH PLAN TO BE SURE ABOUT DENTAL PLAN 3 EXTRA SUPPORT 9 2019 OPEN ENROLLMENT Insurance meets assurance A HEALTH PLAN TO BE SURE ABOUT DENTAL PLAN 3 EXTRA SUPPORT 9 Minnesota North Dakota UNION Mail Handlers Local 323 Dental Program For every smile Simple things

More information

Dental. Lower Colorado River Authority. Network: PDP Plus. L i s t o f P r i m a r y C o v e r e d S e r v i c e s & L i m i t a t i o n s.

Dental. Lower Colorado River Authority. Network: PDP Plus. L i s t o f P r i m a r y C o v e r e d S e r v i c e s & L i m i t a t i o n s. Lower Colorado River Authority Dental Metropolitan Life Insurance Company Network: PDP Plus Coverage Type Type A: Preventive (cleanings, exams, X-rays) Type B: Basic Restorative (fillings, extractions)

More information

Humana Dental Traditional Preferred 14

Humana Dental Traditional Preferred 14 SGB0169A Humana Dental Traditional Preferred 14 LOUISIANA Xavier University of Louisiana-Base Calendar-year deductible (excludes orthodontia services) If you use an IN-NETWORK dentist If you use an OUT-OF-NETWORK

More information

In-Network 100% 80% 50% 40%

In-Network 100% 80% 50% 40% DriveTime Automotive Group, Inc. Dental Network: PDP Plus Standard Plan Coverage Type Type A: Preventive (cleanings, exams, X-rays, composite fillings ) Type B: Basic Restorative (extractions, endodontics,

More information