Pre-paid |
Monthly
Premium |
Employee: $13.59
Employee/Spouse: $22.98
Employee/Child(ren): $29.73
Employee/Family: $34.86 |
Pre-Tax |
Yes |
Deductible |
None |
Co-Payment |
Varies with procedure |
Coverages |
Examinations - No charge
X-rays - No charge
Routine cleanings - No charge
Silver fillings - No charge
Fluoride treatments - No charge
Specialty care available at a 15 to 25 % discount |
Comments |
Must select a DentiCare dentist. Includes limited coverage of vision care. Please read limitations and exclusions. |
Indemnity with PPO Free Choice |
Monthly
Premium |
Employee: $41.48
Employee/Spouse: $79.63
Employee/Child(ren): $93.84
Employee/Family: $124.14 |
Pre-Tax |
Yes |
Deductible |
$50 per person per benefit year |
Co-Payment |
Varies with procedure. Save out of pocket if you go to a PPO provider |
Coverages |
See booklet |
Comment |
Maximum benefit per year is $1,000 per person. May use any dentist of your choice. Save out of pocket if you use a PPO dentist. Includes limited coverage of vision care. |
Pre-paid |
Monthly
Premium |
Employee: $12.64
Employee/Spouse: $21.20
Employee/Child(ren): $23.00
Employee/Family: $32.98 |
Pre-Tax |
Yes |
Deductible |
None |
Maximum Insurance Allowance |
Varies with procedure. Based on copayments. |
Coverages |
Routine cleaning twice a year - No charge
Fluoride treatment - No charge
Fillings (Silver) - No charge
Non-surgical extractions - No charge
Orthodontics and Speciality- 25% discount |
Comments |
Must select an ADP dentist. Please read limitations and exclusions. Includes limited vision benefits. |
Indemnity |
Monthly
Premium |
Employee: $14.74
Employee/Spouse: $21.96
Employee/Child(ren): $23.30
Employee/Family: $37.10 |
Pre-Tax |
Yes |
Deductible |
$50 per person per year; maximum of 3 family members. |
Co-Payment |
Varies with procedure |
Coverages |
Vary with procedure (see percentages in brochure) |
Comments |
Maximum benefit per year is $1,000 per person. May use any dentist of your choice. Includes limited vision benefits. |
Network Plus DHMO Plan |
Monthly
Premium |
Employee: $21.90
Employee/Spouse: $43.18
Employee/Child(ren): $51.48
Employee/Family: $65.76 |
Pre-Tax |
Yes |
Deductible |
None |
Maximum Insurance Allowance |
Varies with Procedure |
Coverages |
- Routine cleaning twice a year - No charge
|
- Fluoride treatment - No charge
|
- Fillings (Silver) - No charge
|
- Non-surgical extractions - No charge
|
- Orthodontics and Specialty - Copayments- By referral from primary care dentist.
|
|
Comments |
Must select a Network Plus DHMO PC dentist. Please read limitations and exclusions. http://www.compbenefits.com/custom/stateofflorida/ |
Preferred Plus DPPO Plan |
Monthly
Premium |
Employee: $29.50
Employee/Spouse: $54.58
Employee/Child(ren): $60.98
Employee/Family: $88.56 |
Pre-Tax |
Yes |
Deductible |
$25 per person per year; maximum $50 family |
Percentage Payment |
Vary with procedure |
Coverages |
Varies with procedure (see payment schedule) |
Comments |
Maximum benefit per year is $1,200 per person. May use any dentist of your choice. Save out of pocket if use a PPO dentist. Please read limitations and exclusions. http://www.compbenefits.com/custom/stateofflorida/ |