NOTE: For groups of 2-99 employees, this product will be limited to renewals as of the 3/1/09 effective date. New and renewing groups of 100+ employees are not affected. View more information.
Benefits
Dental Choice is a cost-effective group dental plan
offering comprehensive coverage for you and your employees.
With ten different packages to choose from, offering
a range of deductibles and coinsurance options, you’re
sure to find the right plan for your group.
Members have the option of visiting both participating
and nonparticipating dentists with all packages. However,
we have negotiated set charges with participating dentists
for given dental services. If members visit a nonparticipating
dentist and the dentist’s fees are greater than
our negotiated charges, the member will be responsible
for any coinsurance, plus the additional amount charged
by the nonparticipating dentist.
Who is Eligible for Benefits Dental Choice is available to groups with two
or more enrolled employees with current Regence BlueShield
of Idaho medical
coverage. Dental Choice is also available on a freestanding
basis for qualified groups. If an eligible employee
chooses dependent coverage, then all dependents must
be covered under the dental plan. Dependents include
the employee's spouse and all eligible children.
Participation Requirements
For groups of 2-50 employees, 100%
of the total number of employees and dependents enrolled
for medical coverage must also enroll in dental coverage.
For groups of 51 or more employees,
100% of the total number of employees enrolled for
medical coverage must also enroll in dental coverage.
If dependent dental coverage is chosen, those dependents
must also have medical coverage.
The program is also available on a freestanding
basis to groups of 15 or more enrolled employees who
currently do not have medical coverage with Regence
BlueShield of Idaho. Dental coverage is contingent
upon 75% of the total number of eligible employees
and dependents enrolling for coverage.
These participation requirements will not include employees
in the process of completing probationary periods.
Dental Package
Options
Packages
Deductible
Coinsurance
Annual Maximum
Package 1
$50 Class I & II
Combined
80% Class I & II
$500
Package 2
$25 Class I
$50 Class II
80% Class I & II
$500
Package 3
$75 Class I, II, III
Combined
80% Class I & II
50% Class III
$1,000
Package 4
$50 Class I & II
Combined
$75 Class III
80% Class I & II
50% Class III
$1,000
Package 5
$25 Class I
$50 Class II
$75 Class III
80% Class I & II
50% Class III
$1,000
Package 6
$50 Class I, II, & III
Combined
100% Class I
80% Class II
50% Class III
$1,000
Package 7
$25 Class I, II, & III
Combined
100% Class I
80% Class II
50% Class III
$1,000
Package 8
$0 Class I
$50 Class II & III
Combined
100% Class I
80% Class II
50% Class III
$1,000
Package 9
$0 Class I
$25 Class II & III
Combined
100% Class I
80% Class II
50% Class III
$1,500
Package 10* Available to groups
of 25 or more enrolled
employees
$0
70% Class I&II
(increases on anniversary date)
50% Class III
(no increase on anniversary date)
$1,000
*No deductible needs to be met. Class I & Class
II services will be paid at 70% of allowable charges
during the first calendar year of a member’s coverage.
At each successive calendar anniversary date, the percentage
payment will be increased by 10% (but never exceeding
100% of allowable charges), provided the member obtained
covered dental services during the most recently completed
calendar year. Class III covered services will be paid
at 50% of allowable charges. The annual maximum is $1,000.
Please note: Groups with 2-5 enrolled employees
with no prior group dental coverage are only eligible
for Packages 1 and 2 for the first 12 months of coverage.
Optional Orthodontic Benefit Orthodontic benefits can be purchased for groups
of 25 or more enrolled employees. Groups without prior
orthodontic coverage will be subject to a 12 month waiting
period. Benefits for orthodontic services will be provided
at 50% of the allowable charge, subject to a lifetime
maximum of $2,000.
Services Covered by Dental Choice
Class I - Preventive and Diagnostic
(partial listing of benefits)
Oral Exams ~ Twice in any calendar year
Cleaning ~ Twice in any calendar year
Fluoride Age 17 and Under ~ Twice in any calendar
year
Bite Wing X-Rays ~ Twice in any calendar year
Full Mouth X-Rays ~ Once every 3 years
Sealants - Age 17 and Under ~ Once in any
4 year period
Space Maintainers ~ Age 11 and under
Class II - Basic Services (partial
listing of benefits)
Palliative Emergency Treatment
Pulp Vitality Tests
Biopsies of Oral Tissue
Endodontics
Fillings
Simple Extractions
Root Canal Treatment
Apicoectomy
Extractions
Hemisection
Periodontal Infection
Anesthesia
Oral Lesions
Mucogingivoplastic Surgery
Class III - Major Restorative (partial
listing of benefits) Prosthodontic Services Including:
Dentures (every 5 years)
Bridgework (every 5 years)
Repairs to Dentures, Bridgework, Inlays and
Onlays
Denture Relining (every 2 years)
Crowns, including repairs
Veneer, subject to Regence BlueShield of Idaho's
approval
Onlays, subject to Regence BlueShield of Idaho's
approval
