Dental Plan

  • $1,500 benefit maximum per plan year for Basic and Major services per covered individual
  • $100 Individual Deductible/$300 Family Deductible (3 or more family members)
  • Preventive benefits – 4 dental cleanings, bitewing x-rays, and fluoride/dental sealants (children under age 18) paid 100% when using PPO dental network providers (not subject to deductible or annual benefit maximum)
  • Basic services such as fillings and root canals are paid at 80% after deductible
  • Major services such as crowns, bridges, and dentures are paid at 50% after deductible
  • To view the entire PY19 Master Plan Document for the Self-Funded PPO Dental Plan click here.
  • To find a dental provider click here.