Voluntary Plan Options with no Waiting Periods

Find the plan that's best for your 10-50 enrolled group

PPO Vol 1

P&D voluntary plan with 2 maximum options
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Starting at
$10.69*
Benefit Summaries
PPO calendar year max$500 or $750
per enrollee
Premier & OON calendar year max$500 or $750
per enrollee
Deductible$0
Per person/per family (excluding P&D)
                Preventive & Diagnostic
Oral exams/evaluations100%
2 per calendar year
Cleanings100%
2 per calendar year
Bitewing X-rays100%
2 per calendar year (through age 18); 1 per calendar year (19+)
Full mouth X-rays100%
1 per 5 years
Sealants100%
Once in a 24-month period per tooth (through age 14)
Topical Fluoride100%
2 per calendar year (through age 18)
Space maintainers100%
1 per arch per lifetime (through age 13)
                Basic Services
Fillings0%

 
Composite/resin restorations0%

 
Simple extractions0%
 
Root canal therapy0%
 
Periodontal maintenance0%
 
Scaling and root planing0%
 
Periodontal surgeries0%
 
Oral surgery0%
 
                Major Services
Single crowns0%

 
Stainless steel crowns0%
 
Crown inlay, only and veneer repairs0%
 
Crown replacement0%
 
Post and core0%
 
Inlays0%
 
Implants0%

 
Bridges0%
(abutment crowns and pontics)
Dentures (complete and partials)0%
 
OrthodonticsNot covered
 
Waiting PeriodsNone
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PPO Vol 2

100/80/50 PPO plan with no waiting periods
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Starting at
$43.53*
Benefit Summary
PPO calendar year max$2,000
per enrollee
Premier & OON calendar year max$2,000
per enrollee
Deductible$50/$150
Per person/per family (excluding P&D)
                Preventive & Diagnostic
Oral exams/evaluations100%
2 per calendar year
Cleanings100%
2 per calendar year
Bitewing X-rays100%
2 per calendar year (through age 18); 1 per calendar year (19+)
Full mouth X-rays100%
1 per 5 years
Sealants100%
Once in a 24-month period per tooth (through age 14)
Topical Fluoride100%
2 per calendar year (through age 18)
Space maintainers100%
1 per arch per lifetime (through age 13)
                Basic Services
Fillings80%
Repeat restorations of same surface payable once in 2 years
Composite/resin restorations80%
Composite resin restorations will be covered on all teeth
Simple extractions80%
1 per lifetime per tooth
Root canal therapy80%
1 per lifetime per tooth
Periodontal maintenance80%
2 per calendar year
Scaling and root planing80%
1 per 2 years per quadrant
Periodontal surgeries80%
1 per 3 years per quadrant
Oral surgery80%
Frequencies vary by procedure code
                Major Services
Single crowns50%
Replacement 1 in 5 years any other major services on the same tooth
Stainless steel crowns50%
Replacement 1 in 2 years
Crown inlay, only and veneer repairs50%
No frequency limitations
Crown replacement50%
Payable 6 months after insertion then 1 in 12 months
Post and core50%
Replacement 1 in 5 years
Inlays50%
Given alternate benefit of a composite filling
Implants50%
Once every 60 months per tooth for ages 16 and older
Bridges50%
1 per 5 years (abutment crowns and pontics)
Dentures (complete and partials)50%
1 placement per 5 years
OrthodonticsNot covered
 
Waiting PeriodsNone
 
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PPO Plus Premier Vol 1

P&D voluntary plan with 2 maximum options
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Starting at
$13.18*
Benefit Summaries
PPO calendar year max$500 or $750
per enrollee
Premier & OON calendar year max$500 or $750
per enrollee
Deductible$0
Per person/per family (excluding P&D)
                Preventive & Diagnostic
Oral exams/evaluations100%
2 per calendar year
Cleanings100%
2 per calendar year
Bitewing X-rays100%
2 per calendar year (through age 18); 1 per calendar year (19+)
Full mouth X-rays100%
1 per 5 years
Sealants100%
Once in a 24-month period per tooth (through age 14)
Topical Fluoride100%
2 per calendar year (through age 18)
Space maintainers100%
1 per arch per lifetime (through age 13)
                Basic Services
Fillings0%

 
Composite/resin restorations0%

 
Simple extractions0%
 
Root canal therapy0%
 
Periodontal maintenance0%
 
Scaling and root planing0%
 
Periodontal surgeries0%
 
Oral surgery0%
 
                Major Services
Single crowns0%

 
Stainless steel crowns0%
 
Crown inlay, only and veneer repairs0%
 
Crown replacement0%
 
Post and core0%
 
Inlays0%
 
Implants0%

 
Bridges0%
(abutment crowns and pontics)
Dentures (complete and partials)0%
 
OrthodonticsNot covered
 
Waiting PeriodsNone
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PPO Plus Premier Vol 2

100/80/50 PPO plan with no waiting periods
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Starting at
$51.95*
Benefit Summary
PPO calendar year max$2,000
per enrollee
Premier & OON calendar year max$1,500
per enrollee
Deductible$50/$150
Per person/per family (excluding P&D)
            Preventive & Diagnostic
Oral exams/evaluations100%
2 per calendar year
Cleanings100%
2 per calendar year
Bitewing X-rays100%
2 per calendar year (through age 18); 1 per calendar year (19+)
Full mouth X-rays100%
1 per 5 years
Sealants100%
Once in a 24-month period per tooth (through age 14)
Topical Fluoride100%
2 per calendar year (through age 18)
Space maintainers100%
1 per arch per lifetime (through age 13)
                Basic Services
Fillings80%
Repeat restorations of same surface payable once in 2 years
Composite/resin restorations80%
Composite resin restorations will be covered on all teeth
Simple extractions80%
1 per lifetime per tooth
Root canal therapy80%
1 per lifetime per tooth
Periodontal maintenance80%
2 per calendar year
Scaling and root planing80%
1 per 2 years per quadrant
Periodontal surgeries80%
1 per 3 years per quadrant
Oral surgery80%
Frequencies vary by procedure code
                Major Services
Single crowns50%
Replacement 1 in 5 years any other major services on the same tooth
Stainless steel crowns50%
Replacement 1 in 2 years
Crown inlay, only and veneer repairs50%
No frequency limitations
Crown replacement50%
Payable 6 months after insertion then 1 in 12 months
Post and core50%
Replacement 1 in 5 years
Inlays50%
Given alternate benefit of a composite filling
Implants50%
Once every 60 months per tooth for ages 16 and older
Bridges50%
1 per 5 years (abutment crowns and pontics)
Dentures (complete and partials)50%
1 placement per 5 years
OrthodonticsNot covered
 
Waiting PeriodsNone
 
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* These are benefit highlights only. Monthly premiums shown are examples only of our lowest monthly rates per employee for employee only coverage. Actual rates vary based on plan choice, your location, and number of people insured. For full details of plans, benefits and pricing, please contact one of our account executives.