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 |
| 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 | $312.72 |
| Student + One | $553.20 |
| Student + Family | $843.84 |
Enhanced Plan
| Basic plan option | Annual Premium |
|---|---|
| Single student | $563.40 |
| Student + One | $996.96 |
| Student + Family | $1,521.24 |