You may choose optional employer-sponsored, employee-paid, dental insurance administered by Anthem. Dental benefits make it easier and more affordable to care for your mouth — and smile. Regular dental checkups help your dentist keep your teeth and gums healthy and catch potential issues earlier, when they're easier to treat. Good oral health can also help improve overall health and reduce the risk of diabetes, heart disease, and other serious health conditions.1
Your dental plan includes:
| Bronze2 | Silver2 | Gold2 | |
| Your Dental Plan at a Glance | In/Out-of-Network3 | In/Out-of-Network3 | In/Out-of-Network3 |
| Annual Benefit Maximum4 | 750 | 1,000 | 1,500 |
| Annual Deductible | 50 | 50 | 50 |
| Orthodontia (only for children through the age of 18) | Not covered | Not covered | 1,500 |
| Diagnostic and Preventive Services | 100%/100% of allowable amount3 | 100%/100% of allowable amount3 | 100%/100% of allowable amount3 |
| Basic Services | 50%/50% of allowable amount3 | 80%/80% of allowable amount3 | 80%/80% of allowable amount3 |
| Oral Surgery (Simple) | 50%/50% of allowable amount3 | 80%/80% of allowable amount3 | 80%/80% of allowable amount3 |
| Major Services5\n(including Complex Oral Surgery,\nPorcelain Crowns, and Implants) | Not covered | 50%/50% of allowable amount3 | 50%/50% of allowable amount3 |
| Annual Maximum Carryover | Not covered | Not covered | Covered |
No waiting periods for basic or major services. Up to 24-month waiting period missing tooth clause.5
| Monthly Rates | Bronze | Silver | Gold |
|---|---|---|---|
| Employee only | $14.08 | $21.40 | $28.40 |
| Employee + spouse | $25.68 | $40.62 | $54.90 |
| Employee + child(ren) | $33.40 | $45.92 | $70.00 |
| Family | $49.28 | $68.26 | $102.10 |
1 Oral Health Foundation. The importance of a healthy smile (accessed October 2021): dentalhealth.org.
2 In-network rates for each tier, out-of-network reimbursement limitations may apply.
3 Difference in charged amount and out-of-network allowable amount can result in balance billing.
4 Dental services exceeding annual benefit maximum(s) are not Covered Services in compliance with applicable state law(s) and participating provider discounts may not apply. Please contact your dentist to
determine available discounts prior to obtaining services. For complete coverage details, please refer to your plan certificate or contact member services.
5 For replacement of congenitally missing teeth or teeth extracted prior to coverage under this plan.