Blue Cross Small Group Plan Designs Dental Plans

Description of Benefits		Blue Cross Small Group Dental Plan Options
		2	20	28	35	36	85	86	87	88	89
Annual Deductible (per member-max 3 members)		$50	$50	$50	$25	$50	$25	$50	$50	$25	$50
Annual Maximum (per member-max 3 members)		$1,000	$1,500	$1,000	$1,500	$1,500/ $1,500 Orthodontic lifetime maximum	$1,000	$1,500	$1,000	$1,500	$1,000
Dental Coinsurance	Preventive (deductible waived)	100%	100%	100%	100%	100%	100%	100%	100%	80%	80%
	Basic Services	80%	80%	80%	80%	80%	80%	80%	80%	50%	50%
	Major Services (1 yr. wait if no prior group cov. within 90 days)	50%	50%	50%	50%	50%	50%	50%	50%	50%	50%
Orthodontic Coverage	Deductible	No Ortho	No Ortho	$50	$25	$50	$25	No Ortho	$50	$25	No Ortho
	Coinsurance			50%	50%	50%	50%		50%	50%
Note: Plan benefits listed above are intended as a summary only and do not replace benefits listed in certificate of coverage. Some specific benefits may have limitations and/or exclusions. Refer to your policy for more detail.
Click here for Blue Cross PPO plans Click here for Blue Cross Group POS plans Click here for Blue Cross Group Open Access POS					Click here for Blue Cross Group HMO plans Click here for Blue Cross Open Access HMO Click here for Individual health plan options
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