This dental plan allows the flexibility to select any dentist in-network or out-of-network, but if you stay in network, you’ll pay less.
Dental coverage focuses on preventive and diagnostic procedures in an effort to avoid more expensive services associated with dental disease and surgery. The type of service or procedure received determines the amount the carrier will cover for each visit. Each type of service fits into a class of services according to complexity and cost.
| Dental Network | In Network | Out-of-Network |
| Individual Deductible | $50 | $50 |
| Family Deductible | $150 | $150 |
| Preventative Coinsurance | $100% | $100% |
| Basic Coinsurance | 80% | 80% |
| Major Coinsurance | 50% | 50% |
| Annual Maximum | $1,000 | $1,000 |
| Orthodontia Coinsurance | Not Covered | Not Covered |
| Orthodontia Lifetime Max | Not Covered | Not Covered |
| Per Pay Period Contributions: | You Pay |
| Employee: | $5.78 |
| Employee + Spouse | $11.56 |
| Employee + Child(ren) | $14.16 |
| Family | $22.83 |
Carrier: BlueCross Blue Shield
Website: www.bcbsil.com/members
Phone: 800-511-6401