Dental Plan Riders

Participants are required to remain in the dental plan for a minimum of two years.
All dependents are covered through the end of the month they turn age 26.
The annual benefit maximums are based on the calendar year and services will follow you throughout the calendar year even when you switch plans mid-year during open enrollment.
Dental Blue plans give you the freedom to see any dentist. However, it is beneficial to see dentists which participate with us as these dentists have agreed to discounted fees, which result in lower out-of-pocket costs for you.

Dental Blue Basic

The Dental Blue Basic plan is intended to provide coverage for most commonly performed dental procedures. This plan offers a specific payment amount for various dental services. To view the payment amounts provided on this plan, please click on the Dental Basic Plan Summary link.

Dental Blue Select

Dental Blue Select represents an enhanced plan design to encourage preventive care and early treatment and also includes coverage for specialized treatment.
Preventive/Diagnostic Services are paid at 100 percent of the BlueShield Fee Schedule.
For Restorative Services, there is an individual deductible of $25.00 and a family deductible of $75.00. 
Restorative Services are paid at 50 percent of the BlueShield Fee Schedule.
Orthodontia Services cover no more than $1,000 per individual’s lifetime up to age 19. The orthodontia benefit is split into two payments with one-half of the total orthodontia maximum paid in year one and the other half paid in year two.
For all other covered services (excluding orthodontia), the maximum payable in a calendar year is $1,000 per individual.
Please click on the Dental Select Plan Summary link to view the benefit summary.

Dental Blue Premier

Dental Blue Premier represents an enhanced plan design to encourage preventive care and early treatment and also includes coverage for specialized treatment. 
Preventive/Diagnostic Services are paid at 100 percent of the BlueShield Fee Schedule.
For Restorative Services, there is an individual deductible of $25.00 and a family deductible of $75.00. 
Restorative Services are paid at 100 percent of the BlueShield Fee Schedule.
Orthodontia Services cover no more than $1,500 per individual’s lifetime.  The orthodontia benefit is split into two payments with one-half of the total orthodontia maximum paid in year one and the other half paid in year two.
For all other covered services (excluding orthodontia), the maximum payable in a calendar year is $1,500 per individual.
Please click on this Dental Premier Plan Summary link to view the benefit summary.