Dental Blue Indemnity
Dental Blue Indemnity offers benefits and broad in-network access. Plans can be customized to best meet an organization's dental care needs.
Dental Blue Indemnity now includes an exciting new benefit. Beginning with January 2009 renewals, all small group dental plans (those with fewer than 51 eligible members) will now include an Accumulated Maximum Rollover benefit on their anniversary date. This rollover benefit will allow each member to roll over certain unused annual dental benefits to be used in a future year (provided they meet specific criteria). Details of this new benefit can be found on the last page of any Summary of Benefits with anniversaries January 1, 2009 or later. This benefit is optional for large groups.
| Preventive Benefit Group |
Basic Benefit Group Coverage |
Basic Benefit Group Deductible |
Maximum | Anniversaries Beginning 1/1/11 |
|---|---|---|---|---|
| 100% | 80% | $25 | $1000 | Summary of Benefits |
| 100% | 80% | $50 | $1000 | Summary of Benefits |
| 100% | 80% | $25 | $750 | Summary of Benefits |
| 100% | 80% | $50 | $750 | Summary of Benefits |
| 100% | 80% | $25 | $500 | Summary of Benefits |
| 100% | 80% | $50 | $500 | Summary of Benefits |
| 100% | 50% | $25 | $750 | Summary of Benefits |
| 100% | 50% | $25 | $500 | Summary of Benefits |
| Preventive Benefit Group | Basic Benefit Group | Major Benefit Group | Basic & Major Deductible | Maximum | Ortho | Anniversaries Beginning 1/1/11 |
|---|---|---|---|---|---|---|
| 100% | 80% | 30% | $50 | $750 | Summary of Benefits | |
| 100% | 80% | 30% | $50 | $1000 | Summary of Benefits | |
| 100% | 80% | 50% | $25 | $1500 | Summary of Benefits | |
| 100% | 80% | 50% | $50 | $1500 | Summary of Benefits | |
| 100% | 80% | 50% | $25 | $1000 | Summary of Benefits | |
| 100% | 80% | 50% | $50 | $1000 | Summary of Benefits | |
| 100% | 80% | 50% | $25 | $750 | Summary of Benefits | |
| 100% | 80% | 50% | $50 | $750 | Summary of Benefits | |
| 100% | 80% | 50% | $50 | $1250 | Summary of Benefits | |
| 100% | 80% | 50% | $50 | $2000 | Summary of Benefits | |
| 100% | 80% | 60% | $50 | $1000 | Summary of Benefits | |
| 100% | 80% | 60% | $50 | $1500 | Summary of Benefits | |
| 100% | 80% | 60% | $50 | $2000 | Summary of Benefits | |
| 100% | 100% | 60% | $50 | $1000 | Summary of Benefits | |
| 100% | 100% | 60% | $50 | $1500 | Summary of Benefits | |
| 100% | 100% | 60% | $50 | $1500 | Summary of Benefits | |
| 100% | 80% | 50% | $25 | $1500 | $1000 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $1500 | $1000 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $1250 | $1000 | Summary of Benefits |
| 100% | 80% | 50% | $25 | $1000 | $1000 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $1000 | $1000 | Summary of Benefits |
| 100% | 80% | 50% | $25 | $750 | $1000 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $750 | $1000 | Summary of Benefits |
| 100% | 80% | 30% | $50 | $750 | $1500 | Summary of Benefits |
| 100% | 80% | 30% | $50 | $1000 | $1500 | Summary of Benefits |
| 100% | 80% | 50% | $25 | $750 | $1500 | Summary of Benefits |
| 100% | 80% | 50% | $25 | $1000 | $1500 | Summary of Benefits |
| 100% | 80% | 50% | $25 | $1500 | $1500 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $750 | $1500 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $1000 | $1500 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $1250 | $1500 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $1500 | $1500 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $2000 | $1500 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $2000 | $1000 | Summary of Benefits |
| 100% | 80% | 50% | $50 | $2000 | $1500 | Summary of Benefits |
| 100% | 80% | 60% | $50 | $1000 | $1000 | Summary of Benefits |
| 100% | 80% | 60% | $50 | $1000 | $1500 | Summary of Benefits |
| 100% | 80% | 60% | $50 | $1500 | $1000 | Summary of Benefits |
| 100% | 80% | 60% | $50 | $1500 | $1500 | Summary of Benefits |
| 100% | 80% | 60% | $50 | $2000 | $1000 | Summary of Benefits |
| 100% | 80% | 60% | $50 | $2000 | $1500 | Summary of Benefits |
| 100% | 100% | 60% | $50 | $1000 | $1000 | Summary of Benefits |
| 100% | 100% | 60% | $50 | $1000 | $1500 | Summary of Benefits |
| 100% | 100% | 60% | $50 | $1500 | $1000 | Summary of Benefits |
| 100% | 100% | 60% | $50 | $1500 | $1500 | Summary of Benefits |
| 100% | 100% | 60% | $50 | $2000 | $1000 | Summary of Benefits |
| 100% | 100% | 60% | $50 | $2000 | $1500 | Summary of Benefits |
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