BUSINESS DENTAL OPTIONS. My employees want dental options.

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1 BUSINESS DENTAL OPTIONS My employees want dental options.

2 These are our options. MyBlueDental SM PLAN FEATURES MyBlueDental offers your employees more complete dental benefits and two choices for coverage levels. Available with any plan. Preventive care Restorative care Major restorative care Orthodontic care (optional) Standard or High Option benefits Combined Dental/Vision PLAN FEATURES The Dental/Vision option gives your employees basic dental benefits with the added bonus of vision benefits. Not available with all Business Blue SM plans. Preventive care Restorative care Eye exam coverage Coverage for frames, lenses and contacts 2

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4 Why offer dental coverage? Did you know that good oral health is linked to good overall health and wellness? Your employees do. Dental coverage is the second most requested benefit by employees. Dental coverage gives your employees access to important care that adults and children need for good oral health and BlueCross BlueShield of South Carolina gives you more coverage choices. Whether you need basic coverage or more complete coverage, choose Blue for your employees. MyBlueDental MyBlueDental is your plan if you want more complete dental coverage for your employees. This plan is available to companies with two or more enrolled employees. 1 Optional orthodontic benefits (for repositioning of teeth) are available to companies with 13 or more enrolled employees.* Standard Option Pays maximum of $1,000 per member, per benefit period ($500 lifetime maximum for optional orthodontic coverage). Orthodontic Coverage High Option Pays maximum of $2,000 per member, per benefit period ($1,000 lifetime maximum for optional orthodontic coverage). Orthodontic Coverage You get these dental features: No deductible for preventive services Coverage for basic restorative services such as root canals, routine fillings and extractions Coverage for major restorative services such as crowns, dentures and bridges Coverage for children s orthodontic care Preventive Care Restorative Care 2 Major Restorative Care 2 Orthodontic Care percent of allowed charges 80 percent of allowed charges 50 percent of allowed charges 50 percent of allowed charges Checkups Cleanings Fluoride Treatments Space maintainers Emergency treatment for pain X-rays Simple and surgical teeth removal Oral surgery Anesthesia Fillings Treatments involving the bones, tissues and gums surrounding and supporting a tooth Crowns Bridges Dentures (removable) Inlays Denture and bridge repair Available for employees under age 19 and dependents under age 19 Orthodontic care not covered unless it is purchased by the group 4

5 Choose Your Provider MyBlueDental gives you the freedom to select any dentist you like. Keep in mind that the dentist you choose can bill you for the balance not covered by the plan. So it s wise to check a dentist s pricing and billing practices before selection and treatment. Maximum Benefits With MyBlueDental, you have two plans to choose from Standard Option and High Option. The Standard Option plan has a lower premium and pays lower allowable charges for covered services. The High Option has a slightly higher premium but pays higher allowable charges. Preventive care, restorative care and major restorative care Optional orthodontic care For employees under age 19 and dependents under age 19 Standard Option High Option $1,000 per person each year $2,000 per person each year $500 maximum lifetime benefit $1,000 maximum lifetime benefit There is a six-month waiting period for major restorative care benefits. We ll waive any part of the six-month waiting period that employees have already met under a previous dental plan if it has been in effect for at least six months. Below are three examples of common dental procedures and how they are paid under each option. Examples Please note that the allowances listed are subject to change without notice. Procedure Dentist s Charge Standard Option High Option Allowance Payment Allowance 4 Payment Periodic oral exam $45 $16 $16 $35 $35 Crown porcelain $900 $425 $ $800 $400 Amalgam filling two surfaces, permanent $140 $51 $40.80 $134 $ Groups with dental-only coverage must have seven or more enrolled employees. For groups of two to six employees, dental level of coverage must match level of health coverage chosen. 2 There is a $50 deductible that applies to restorative and major restorative care. 3 Available for employees under age 19 and dependents under age High Option allowances are ZIP-code based. 5

6 Combined Dental/Vision Benefit Our Combined Dental/Vision is a cost-effective way to provide general coverage for periodic cleaning and exams. It also covers basic restorative care, up to your benefit limit. You ll also get coverage for a yearly eye exam and payments toward frames, lenses and contacts. This is an optional benefit available with Business True Blue SM Value Plans, Business Blue SM Secure and Business Blue SM Basic. Dental Preventive Care 100 percent of allowed charges* Checkups: Two per benefit period Cleaning: Two per benefit period X-rays: One set per benefit period Emergency treatment for pain (subject to $300 limit) Restorative Care 50 percent of allowed charges* Simple and surgical teeth removal, not including impacted teeth Fillings Anesthesia Oral surgery Dental/Vision level of coverage must match level of health coverage chosen. * Combined maximum of $300 dental benefit per benefit period. Vision Eye exam: 100 percent of allowed charges** Frames and lenses or contact lenses: 100 percent of allowed charges** Discounts are also available to members with Vision One. ** $100 maximum per eye exam per benefit period. $50 maximum payment per member, per benefit period for frames and lenses or contact lenses. Exclusions and Limitations for All Dental Benefits Cosmetic procedures Any procedure started before the effective date of coverage Replacement of teeth that were missing before the effective date of coverage Implants This is a general summary of exclusions. For a complete description, please refer to your dental benefits booklet. Some additional restrictions and/or exclusions apply. For more information on our dental benefits, contact your local BlueCross agent or call us at , ext

7 Exclusions and Limitations Cosmetic procedures Any procedure started before the effective date of coverage Replacement of teeth that were missing before the effective date of coverage Implants This is a general summary of exclusions. For a complete description, please refer to your dental benefits booklet. Some additional restrictions and/or exclusions apply.

8 visit us online at SouthCarolinaBlues.com BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association M