Dental Select PPO Plus traditional plans
Here is a selection of the most popular traditional group dental plans for employers with 51+ employees. With these
plans, employers pay a portion of the member’s premium. We have many other plans to consider also.
You’ll notice three different coinsurance numbers. The first coinsurance amount is when members visit providers
exclusively in the PPO network. The second coinsurance is the broad DentalBlue PPP network. The third coinsurance
number
is for services received from out-of-network providers.
Select PPO Plus 1102
|
---|
Deductible Amount
| |
Individual
| $50
|
Family
| $150
|
Calendar-year Maximum
| |
In Network
| $1,000
|
Out of Network
| $1,000
|
Employee pays after deductible
|
Preventive and Diagnostic
| |
PPO
| 0%
|
PPP
| 0%
|
Out of Network
| 10%
|
Minor Services
| |
PPO
| 20%
|
PPP
| 20%
|
Out of Network
| 30%
|
Major Services
| |
PPO
| 50%
|
PPP
| 50%
|
Out of Network
| 60%
|
Orthodontic Services
| NA
|
Select PPO Plus 1103
|
---|
Deductible Amount
| |
Individual
| $50
|
Family
| $150
|
Calendar-year Maximum
| |
In Network
| $1,500
|
Out of Network
| $1,000
|
Employee pays after deductible
|
Preventive and Diagnostic
| |
PPO
| 0%
|
PPP
| 0%
|
Out of Network
| 10%
|
Minor Services
| |
PPO
| 20%
|
PPP
| 20%
|
Out of Network
| 30%
|
Major Services
| |
PPO
| 50%
|
PPP
| 50%
|
Out of Network
| 60%
|
Orthodontic Services
| NA
|
Select PPO Plus 2101
|
---|
Deductible Amount
| |
Individual
| $50
|
Family
| $150
|
Calendar-year Maximum
| |
In Network
| $1,000
|
Out of Network
| $1,000
|
Employee pays after deductible
|
Preventive and Diagnostic
| |
PPO
| 0%
|
PPP
| 0%
|
Out of Network
| 10%
|
Minor Services
| |
PPO
| 20%
|
PPP
| 20%
|
Out of Network
| 30%
|
Major Services
| |
PPO
| 50%
|
PPP
| 50%
|
Out of Network
| 60%
|
Orthodontic Services
| NA
|
Select PPO Plus 3101
|
---|
Deductible Amount
| |
Individual
| $50
|
Family
| $150
|
Calendar-year Maximum
| |
In Network
| $1,000
|
Out of Network
| $1,000
|
Employee pays after deductible
|
Preventive and Diagnostic
| |
PPO
| 0%
|
PPP
| 0%
|
Out of Network
| 10%
|
Minor Services
| |
PPO
| 20%
|
PPP
| 20%
|
Out of Network
| 30%
|
Major Services
| |
PPO
| 50%
|
PPP
| 50%
|
Out of Network
| 60%
|
Orthodontic Services
| |
PPO
| 50%
|
PPP
| 50%
|
Out of Network
| 60%
|
Orthodontic Lifetime Max
| $1,000
|
Select PPO Plus 3102
|
---|
Deductible Amount
| |
Individual
| $50
|
Family
| $150
|
Calendar-year Maximum
| |
In Network
| $1,500
|
Out of Network
| $1,000
|
Employee pays after deductible
|
Preventive and Diagnostic
| |
PPO
| 0%
|
PPP
| 0%
|
Out of Network
| 10%
|
Minor Services
| |
PPO
| 20%
|
PPP
| 20%
|
Out of Network
| 30%
|
Major Services
| |
PPO
| 50%
|
PPP
| 50%
|
Out of Network
| 60%
|
Orthodontic Services
| |
PPO
| 50%
|
PPP
| 50%
|
Out of Network
| 60%
|
Orthodontic Lifetime Max
| $1,500
|
Select PPO Plus 4101
|
---|
Deductible Amount
| |
Individual
| $50
|
Family
| $150
|
Calendar-year Maximum
| |
In Network
| $1,000
|
Out of Network
| $1,000
|
Employee pays after deductible
|
Preventive and Diagnostic
| |
PPO
| 0%
|
PPP
| 0%
|
Out of Network
| 10%
|
Minor Services
| |
PPO
| 20%
|
PPP
| 20%
|
Out of Network
| 30%
|
Major Services
| |
PPO
| 50%
|
PPP
| 50%
|
Out of Network
| 60%
|
Orthodontic Services
| |
PPO
| 50%
|
PPP
| 50%
|
Out of Network
| 60%
|
Orthodontic Lifetime Max
| $1,000
|