We’ve Got You Covered

All preventive services are paid after a deductible. Routine exams and cleanings are covered at 100%.

Network Options

Available on our nationwide Platinum network. Utah and Texas subscribers may also choose to enroll on our regional Gold Network.

Vision Coverage Too

All members are also covered by the EyeMed Discount Vision plan included at no cost, offering discounts at top vision retailers nationwide.

Discounts

Additional discounts available on teeth bleaching and cosmetic services.

Plan Highlights

  • Customizable plan benefits
  • Annual Maximum increments up to $5,000 or Unlimited (where available)
  • MaxRewardsSM available for groups 2+
  • Adult & child Orthodontic benefit options
  • Implant benefits available
  • Self-funded plans available
  • Dual option plans available
  • Includes non-insured cosmetic discounts
  • Nationwide dentist network access

Plan Summary

In-Network

Out-of-Network

Preventive
Includes cleanings (2 per year), exams, flouride (14 & under) & x-rays
In-Network
100%
Out-of-Network
100% of Fee Schedule
Basic
Includes fillings & oral surgery
In-Network
70%
Out-of-Network
70% of Fee Schedule
Waiting Period - Basic
In-Network
6 months
Out-of-Network
6 months
Major
Includes crowns, bridges, periodontics, endodontics & dentures
In-Network
50%
Out-of-Network
50% of Fee Schedule
Waiting Period - Major
In-Network
18 Months
Out-of-Network
18 Months
Deductible
Per effective date year. Applies to all services.
In-Network
$75 / $225 per person/ per family
Out-of-Network
$75 / $225 per person/ per family
Maximum Benefit
Per member, per effective date year. Applies to services excluding orthodontics.
In-Network
$1000 of which $500 per year can be used for major services
Out-of-Network
$1000 of which $500 per year can be used for major services
Orthodontics
Children & Adults
In-Network
20% Discount
Out-of-Network
N/A
Orthodontics Maximum
In-Network
Unlimited
Out-of-Network
N/A
Orthodontic Waiting Periods
In-Network
None
Out-of-Network
N/A

FAQ

Which networks can I use?
When is my plan effective?
Who can I include on my plan?
Does my plan include Vision?
Additional inclusions for Seniors
What if I require specialist services?
Where can I find a copy of my plan brochure?
To which services does my deductible apply?

Legal

Plan Exclusions

Important Notice: This information is a brief description of the important features of the insurance plan. It is not a contract of insurance. The terms and conditions of coverage are set forth in the policies issued in the state in which the policy was delivered. Complete details may be found in the policies. The policy is subject to the laws of the state in which it was issued. Chubb NA is the U.S.-based operating division of the Chubb Group of Companies, headed by Chubb, Ltd. (NYSE: CB) Insurance products and services are provided by Chubb Insurance underwriting companies and not by the parent company itself.

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