Dental Plan Summaries

• DMO
• DMO with Orthodontia
• Standard PPO
• Standard PPO with Orthodontia
• Enhanced PPO
• Enhanced PPO with Orthodontia
• Passive PPO; 100/80/50; No Orthodontia; $1,000 max.

The following plans are no longer available to new business. These plan summaries are provided for grandfathered companies only.

• Passive Basic PPO; 100/80/0; No Orthodontia; $1,000 max.
• Passive PPO; 100/80/50; No Orthodontia; $1,500 max.
• Passive PPO; 100/80/50; With Orthodontia; $1,000 max.
• Passive PPO; 100/80/50; With Orthodontia; $1,500 max.
• Dental DMO