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Dental Select PPO Plus voluntary plans
Here is a selection of the most popular voluntary group dental plans for employers with 2-50 employees. Employers can choose voluntary coverage without making a financial contribution. We have many additional plans for your consideration.
| Essential 1000SRV | |
|---|---|
| Deductible Amount | |
| Individual | NA |
| Family | NA |
| Annual Maximum* | |
| In Network | $1,000 |
| Out of Network | $1,000 |
| Employee pays after deductible | |
| Preventive** | |
| PPO | 100% |
| PPP | 100% |
| Out of Network | 80% |
| Minor services** | |
| PPO | NA |
| PPP | NA |
| Out of Network | NA |
| Major Services** | |
| PPO | NA |
| PPP | NA |
| Out of Network | NA |
| Endodontic/Periodontal*** | NA |
| Orthodontic Services**** | |
| PPO | NA |
| PPP | NA |
| Out of Network | NA |
| Orthodontic lifetime maximum | NA |
| Maximum rollover | NA |
| Value 1000SRV | |
|---|---|
| Deductible Amount | |
| Individual | $50 |
| Family | $150 |
| Annual Maximum* | |
| In Network | $1,000 |
| Out of Network | $1,000 |
| Employee pays after deductible | |
| Preventive** | |
| PPO | 100% |
| PPP | 100% |
| Out of Network | 90% |
| Minor services** | |
| PPO | 80% |
| PPP | 80% |
| Out of Network | 70% |
| Major Services** | |
| PPO | 50% |
| PPP | 50% |
| Out of Network | 40% |
| Endodontic/Periodontal*** | Major |
| Orthodontic Services**** | |
| PPO | 50% |
| PPP | 50% |
| Out of Network | 40% |
| Orthodontic lifetime maximum | $1,000 |
| Maximum rollover | Included |
| Elite 1000SRV | |
|---|---|
| Deductible Amount | |
| Individual | $50 |
| Family | $150 |
| Annual Maximum* | |
| In Network | $1,000 |
| Out of Network | $1,000 |
| Employee pays after deductible | |
| Preventive** | |
| PPO | 100% |
| PPP | 100% |
| Out of Network | 90% |
| Minor services** | |
| PPO | 80% |
| PPP | 80% |
| Out of Network | 70% |
| Major Services** | |
| PPO | 50% |
| PPP | 50% |
| Out of Network | 40% |
| Endodontic/Periodontal*** | Basic |
| Orthodontic Services**** | |
| PPO | 50% |
| PPP | 50% |
| Out of Network | 40% |
| Orthodontic lifetime maximum | $1,000 |
| Maximum rollover | Included |
| Elite 1500SRV | |
|---|---|
| Deductible Amount | |
| Individual | $50 |
| Family | $150 |
| Annual Maximum* | |
| In Network | $1,500 |
| Out of Network | $1,000 |
| Employee pays after deductible | |
| Preventive** | |
| PPO | 100% |
| PPP | 100% |
| Out of Network | 90% |
| Minor services** | |
| PPO | 80% |
| PPP | 80% |
| Out of Network | 70% |
| Major Services** | |
| PPO | 50% |
| PPP | 50% |
| Out of Network | 40% |
| Endodontic/Periodontal*** | Basic |
| Orthodontic Services**** | |
| PPO | 50% |
| PPP | 50% |
| Out of Network | 40% |
| Orthodontic lifetime maximum | $1,500 |
| Maximum rollover | Included |
| Elite 2000SRV | |
|---|---|
| Deductible Amount | |
| Individual | $50 |
| Family | $150 |
| Annual Maximum* | |
| In Network | $2,000 |
| Out of Network | $1,500 |
| Employee pays after deductible | |
| Preventive** | |
| PPO | 100% |
| PPP | 100% |
| Out of Network | 90% |
| Minor services** | |
| PPO | 80% |
| PPP | 80% |
| Out of Network | 70% |
| Major Services** | |
| PPO | 50% |
| PPP | 50% |
| Out of Network | 40% |
| Endodontic/Periodontal*** | Basic |
| Orthodontic Services**** | |
| PPO | 50% |
| PPP | 50% |
| Out of Network | 40% |
| Orthodontic lifetime maximum | $2,000 |
| Maximum rollover | Included |
*Annual max for Par/Non-Par is cumulative not separate for all plans
**Periodontal maintenance is not covered in P5000 and PV5000 (D4910). Periodontal maintenance is covered as a basic service in plans P5001, P5002, P5003, P5004, PV5001, PV5002, PV5003, PV5004
***Refers to endodontic (root canals, etc.), Periodontic (treatment of gum disease, etc.) and certain oral surgery procedures
****Orthodontic services are limited to covered persons through age 18