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This in-network plan offers a higher level of coverage for preventative care and minor restorative procedures, and core coverage for major restorative procedures with the highest per person pay out at effective 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 Enhanced Coverage
| Beneficiaries | 12-Month Pay Structure | 9-Month Pay Structure |
|---|---|---|
| Single | $20.90 | $25.48 |
| One Parent and Child/ren | $59.02 | $72.12 |
| Two Adults | $88.34 | $108.04 |
| Family | $106.16 | $129.72 |
Half-Time Enhanced Coverage
| Beneficiaries | 12-Month Pay Structure | 9-Month Pay Structure |
|---|---|---|
| Single | $33.56 | $41 |
| One Parent and Child/ren | $71.70 | $87.60 |
| Two Adults | $101.04 | $123.50 |
| Family | $118.82 | $145.22 |