Voluntary plan options with no waiting periods

Find the Voluntary plan with P&D, Basic, and Major Services – and no waiting periods that's best for your 2-9 enrolled group; includes our two new Voluntary plan options

PPO Voluntary 1

P&D only plan option
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Starting at
$11.02*
Benefit Summaries
PPO calendar year maximum$500 or $750
per enrollee
Premier & Out of Network calendar year maximum$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
FillingsNot covered
Repeat restorations of same surface payable once in 2 years
Composite/resin restorationsNot covered

 
Simple extractionsNot covered
 
Root canal therapyNot covered
 
Periodontal maintenanceNot covered
 
Scaling and root planingNot covered
 
Periodontal surgeriesNot covered
 
Oral surgeryNot covered
 
                Major Services
Single crownsNot covered
 
Stainless steel crownsNot covered
 
Crown inlay, only and veneer repairsNot covered
 
Crown replacementNot covered
 
Post and coreNot covered
 
InlaysNot covered
 
ImplantsNot covered

 
BridgesNot covered
(abutment crowns and pontics)
Dentures (complete and partials)Not covered
 
OrthodonticsNot covered
 
Waiting PeriodsNone
 
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PPO Voluntary 3

100/80/50 voluntary plan options
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Starting at
$40.19*
Benefit Summary
PPO calendar year maximum$1,000, $1,500, or $2,000
per enrollee
Premier & Out of Network calendar year maximum$1,000, $1,500, or $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%
1 per lifetime 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 against itself
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 at the restorative copay
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 initial placement per 5 years
OrthodonticsNot covered
 
Waiting PeriodsNone
 
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PPO Plus Premier Voluntary 3

100/80/50 voluntary plan options
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Starting at
$49.03*
Benefit Summary
PPO calendar year maximum$1,000, $1,500, or $2,000
per enrollee
Premier & Out of Network calendar year maximum$750, $1,000, or $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%
1 per lifetime 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 against itself
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 at the restorative copay
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 initial 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.