Dental Plan Summaries

Plan Summaries

for plans available beginning Oct. 1, 2007

• DMO
• DMO with Orthodontia
• Standard PPO
• Standard PPO with Orthodontia
• Enhanced PPO
• Enhanced PPO with Orthodontia

Plan Summaries
for plans available prior to Oct. 1, 2007

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