Dental Plan Options and Costs

Important Note:

  • Be sure to ask whether you are making an appointment with a PPO or Premium service provider when making appointments to avoid unanticipated fees. It is possible for two dentists working in the same practice to be members of different networks. 

Basic Plan Benefits

  ppo Provider premier provider/ out of network provider
Preventative and diagnostics 100% 100%
Fillings and simple extractions 80% 50%
Deductible $50 $50
maximum $1000 $500

Enhanced Plan Benefits 
 
  ppo provider premier provider/ Out of network provider
preventative and diagnostics 100% 100%
fillings and simple extractions 80% 50%
sealants 80% 80%
root canals, periodontics, oral surgery 50% 50%
crowns and gold restorations, bridgework, dentures 50% 50%
deductible $50 $50
maximum $1500 $1000

The annual premiums for dental coverage are as follows:

Basic Plan

Basic plan option Annual Premium
Single student $289.32
Student + One $511.80
Student + Family $780.84

Enhanced Plan

Basic plan option Annual Premium
Single student $521.40
Student + One $922.56
Student + Family $1,407.60