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This in-network plan offers core coverage on preventative and minor/major restorative care for the lowest monthly premiums.

It is important to note that services are based on a rolling 12-month period, not a calendar year period. For example, diagnostic/preventive evaluations are covered twice in a rolling 12-month period.

Plan Costs

Full-Time Basic Coverage

Beneficiaries 12-Month Pay Structure 9-Month Pay Structure
Single $5.12 $6.22
One Parent and Child/ren $31.16 $38.08
Two Adults $51.22 $62.58
Family $61.54 $75.20

Half-Time Basic Coverage

Beneficiaries 12-Month Pay Structure 9-Month Pay Structure
Single $17.82 $21.76
One Parent and Child/ren $43.82 $53.54
Two Adults $63.86 $78.08
Family $70.52 $86.18