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ARTICLE About Our Dental Plans


Our broad portfolio of dental products makes it easy to find a plan that's right for you.


 

Plan Features Ideal for
customers who...
Flexibility ranking Cost ranking Available for
PPO/Open Access Preferred Provider Organization

Passive and active open access plans in most states

In-and out-of-network coverage

No referrals necessary

Featuring some of the nation's largest networks

Want to offer their employees maximum flexibility with significant network savings of 35% on average ***** $$$$

Fully insured groups of two or more

Self-funded options available for large groups only

Certain optional features available for groups of 10 or more only

Available on a voluntary or contributory basis

Gateway PPO
Preferred Provider Organization

Plans with cost-saving benefit designs

Priced 15% below standard PPO plan due to class shifting for endodontic and periodontal services and full mouth and panoramic X-rays

In-and out-of-network coverage

No referrals necessary

Featuring some of the nation's largest networks

Want to offer comprehensive benefits and broad access while reducing costs *** $$$

Fully insured groups of two or more

Self-funded options available for large groups only

Available on a voluntary or contributory basis

INO
In-Network only


Available in some states

When comparing Usual and Customary-based plans: Priced 25% below similar PPO plan

No referrals necessary

Featuring some of the nation's largest networks

Want to offer a cost-saving managed care plan with broad open access network and flexible plan designs ** $$

Fully insured groups of two or more

Self-funded options available for large groups only

Available on a voluntary or contributory basis

Indemnity

No network restrictions – maximum flexibility

No network discounts

Timely reimbursements – member pays at time of service and submits claim

Payment based on fee schedule of 85% of usual and customary. Member pays difference if fee is higher than set amount

Have employees located in areas where network is not adequate to offer equal benefits to all employees **** $$$$$

Fully and self-insured groups of two or more

Available on a voluntary or contributory basis

Select Managed Care Plans
Dental Maintenance Organization & Direct Compensation

Available in select states.

Simple plan designs – predictable copays, no deductibles, no annual max

Large regional networks (varies by location)

Maximum savings – typically priced about 50% less than PPO plan

In-network coverage only with most plans

Primary care dentist coordinates all care (most plans)

Referrals required for specialty care (most plans)

Are looking for maximum savings and a plan that is simple to use. * $

For fully insured groups of two or more

Available on a voluntary or contributory basis.