These dental plans allow 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 | Low Plan In-Network / Out-of-Network | High Plan In-Network / Out-of-Network |
| Individual Deductible | $50 / $50 | $50 / $50 |
| Family Deductible | $150 / $100 | $150 / $100 |
| Preventative Coinsurance | $100% / 80% | $100% / 100% |
| Basic Coinsurance | 80% / 70% | 90% / 80% |
| Major Coinsurance | 50% / 40% | 60% / 50% |
| Annual Maximum | $1,000 / $1,000 | $1,500 / $1,500 |
| Orthodontia Coinsurance | Not Covered | 50% / 50% |
| Orthodontia Lifetime Max | Not Covered | $1,000 / $1,000 |
| Per Pay Period Contributions: | Low Plan | High Plan |
| Employee: | $4.22 | $5.93 |
| Employee + Spouse | $8.78 | $12.03 |
| Employee + Child(ren) | $10.88 | $16.35 |
| Family | $16.20 | $23.80 |
Carrier: BlueCross Blue Shield
Website: www.bcbsil.com/members
Phone: 800-511-6401