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MedicalPPO HMO
DentalLife Insurance |
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Dental
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New Dental Plan Providers and Options Check out our new Dental Plan Options selected to meet the needs of our diverse workforce. |
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The State of Florida offers you comprehensive dental coverage through a wide array of Dental Plans. And this year we're adding even more!
New Dental Plan Providers
We've contracted with three new Dental Plan providers to supplement our current list and bring you even more options.
Each plan is designed to meet the needs of employees based on their individual plan usage, flexibility in using in- or non-network dentists, and cost.
Types of Plans and Covered Services
The Dental Plans are divided into three categories: PPO, Indemnity and Dental HMO with varying premium levels and out-of-pocket costs.
View the plans by type:
| PPO | ||
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CompBenefits 4054 |
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Monthly Premiums |
$26.82 |
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In-Network |
Out-of-Network |
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Annual Deductible |
Employee: $25 |
Employee: $50 |
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Calendar Year Maximum |
$1,200 per person |
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Preventive Care (no deductible) |
You pay |
You pay |
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Periodic oral exam (ADA 103, 120) |
$0 |
20% |
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Bite-wing X-rays (ADA 274) |
$0 |
20% |
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Cleanings (Dental Prophylaxis - ADA 1110) |
$0 |
20% |
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Fluoride treatments (ADA 1201, 1203) |
$0 |
20% |
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Sealants (ADA 1351) |
$0 |
20% |
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Space maintainers (ADA 1515) |
$0** |
20% |
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Basic and Major Care (for PPO and Indemnity plans, deductible applies) |
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Complete series or panoramic X-rays (ADA 210/330) |
$0 |
20% |
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Amalgam fillings (ADA 2150) |
20% |
50% |
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Composite resin fillings (ADA 2331) |
20% |
50% |
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Root canal (ADA 3330) |
20% |
50% |
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Periodontal surgery - gingivecotomy, per quadrant (ADA 4210) |
20% |
50% |
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Root planing, per quadrant (ADA 4341) |
20% |
50% |
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Surgical extraction of tooth, including wisdom teeth (ADA 7240) |
20% |
50% |
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General anesthesia, each 30 minutes (ADA 9220, 9230) |
20% |
50% |
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Crowns (ADA 2750) |
50% |
70% |
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Fixed bridges (ADA 6240) |
50% |
70% |
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Full lower denture (ADA 5120) |
50% |
70% |
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Inlays and onlays (ADA 2520) |
50% |
70% |
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Partial dentures (ADA 5214) |
50% |
70% |
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Re-cement bridges, crowns, inlays (ADA 2920) |
50% |
70% |
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Relining dentures (ADA 5730) |
50% |
70% |
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Repairs to full dentures, partial dentures, bridges (ADA 5510) |
50% |
70% |
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Orthodontia Care |
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Child 24-month treatment fee (ADA 8670) |
50%; $1,500 lifetime max benefit |
100% |
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Adult 24-month treatment fee (ADA 8670) |
50%; $1,500 lifetime max benefit |
100% |
**limited to children under age 16
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Indemnity | ||
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Ameritas |
Assurant |
American Dental Plan |
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Monthly Premiums |
$8.84 |
$38.35 |
$14.74 |
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Annual Deductible |
$50 |
$50/person; |
$50 |
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Calendar Year Maximum |
$1,000/person |
$1,250/person in network; $1,000/person out-of-network |
$1,000/person |
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Preventive Care (no deductible) |
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Periodic oral exam (ADA 103, 120) |
Cost above $14 |
$0 |
Cost above $11.70 |
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Bite-wing X-rays (ADA 274) |
Cost above $20 |
$0 |
Cost above $16.20 |
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Cleanings (Dental Prophylaxis - ADA 1110) |
Cost above $30 |
$0 |
Cost above $18.90 |
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Fluoride treatments (ADA 1201, 1203) |
Cost above $11 |
$0 |
Cost above $15.30 |
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Sealants (ADA 1351) |
Cost above $17 |
$0 |
Cost above $6.30/tooth |
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Space maintainers (ADA 1515) |
Cost above $174 |
$0 |
Cost above $108 |
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Basic and Major Care (for PPO and Indemnity plans, deductible applies) |
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Complete series or panoramic X-rays (ADA 210/330) |
Cost above $45 |
20% |
Cost above $23.40 |
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Amalgam fillings (ADA 2150) |
Cost above $32 |
20% |
Cost above $18 |
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Composite resin fillings (ADA 2331) |
Cost above $38 |
20% |
Cost above $22.50 |
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Root canal (ADA 3330) |
Cost above $238 |
75%* |
Cost above $243 |
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Periodontal surgery - gingivecotomy, per quadrant (ADA 4210) |
Cost above $253 |
75%* |
Cost above $51.30 |
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Root planing, per quadrant (ADA 4341) |
Cost above $52 |
75%* |
Cost above $14.40 |
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Surgical extraction of tooth, including wisdom teeth (ADA 7240) |
Cost above $104 |
20% |
Cost above $61.60 |
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General anesthesia, each 30 minutes (ADA 9220, 9230) |
Cost above $80 |
20% |
Cost above $30.60 |
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Crowns (ADA 2750) |
Cost above $156 |
75%* |
Cost above $180 |
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Fixed bridges (ADA 6240) |
Cost above $151 |
75%* |
Cost above $180 |
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Full lower denture (ADA 5120) |
Cost above $166 |
75%* |
Cost above $129.60 |
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Inlays and onlays (ADA 2520) |
Cost above $123 |
75%* |
Cost above $26.10 |
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Partial dentures (ADA 5214) |
Cost above $193 |
75%* |
Cost above $79.20 |
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Re-cement bridges, crowns, inlays (ADA 2920) |
Cost above $12 |
75%* |
Cost above $11.70 |
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Relining dentures (ADA 5730) |
Cost above $58 |
75%* |
Cost above $32.40 |
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Repairs to full dentures, partial dentures, bridges (ADA 5510) |
Cost above $32 |
75%* |
Cost above $26.10 |
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Orthodontia Care |
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Child 24-month treatment fee (ADA 8670) |
100% |
50%; $1,000/ child lifetime max benefit |
100% |
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Adult 24-month treatment fee (ADA 8670) |
100% |
100% |
100% |
*75% for first year; 50% for subsequent years of consecutive coverage
**limited to children under age 16
| Dental HMO / Pre-paid (In-Network Only) | |||||
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CompBenefits |
UnitedHealthcare |
Assurant |
CIGNA |
American Dental Plan |
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Monthly Premiums |
$16.22 |
$10.91 |
$12.35 |
$23.46 |
$12.64 |
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Annual Deductible |
$0 |
$0 |
$0 |
$0 |
$0 |
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Calendar Year Maximum |
$0 |
$0 |
$0 |
$0 |
$0 |
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Preventive Care (no deductible) |
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Periodic oral exam (ADA 103, 120) |
$0 |
$0 |
$0 |
$0 |
$0 |
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Bite-wing X-rays (ADA 274) |
$0 |
$0 |
$0 |
$0 |
$0 |
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Cleanings (Dental Prophylaxis - ADA 1110) |
$0 |
$0 |
$0 |
$0 |
$0 |
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Fluoride treatments (ADA 1201, 1203) |
$0 |
$0 |
$0 |
$0 |
$0 |
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Sealants (ADA 1351) |
$0 |
$0 |
$10/tooth |
$10/tooth |
$7/tooth |
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Space maintainers (ADA 1515) |
$0 |
$0 |
$60 |
$155 |
$45 |
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Basic and Major Care (for PPO and Indemnity plans, deductible applies) |
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Complete series or panoramic X-rays (ADA 210/330) |
$0 |
$0 |
$0 |
$0 |
$0 |
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Amalgam fillings (ADA 2150) |
$8 |
$0 |
$15 |
$0 |
$0 |
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Composite resin fillings (ADA 2331) |
$10 |
$37 |
$45 |
$0 |
$37 |
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Root canal (ADA 3330) |
$64 |
$245 |
$245 |
$280 |
$240 |
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Periodontal surgery - gingivecotomy, per quadrant (ADA 4210) |
$39 |
$175 |
$120 |
$140 |
$120 |
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Root planing, per quadrant (ADA 4341) |
$14 |
$50 |
$50 |
$70 |
$45 |
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Surgical extraction of tooth, including wisdom teeth (ADA 7240) |
$27 |
$80 |
$100 |
$95 |
$75 |
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General anesthesia, each 30 minutes (ADA 9220, 9230) |
$23 |
$125 |
$180 |
$145 |
$15 |
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Crowns (ADA 2750) |
$150 |
$245 |
$265 |
$425 |
$220 |
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Fixed bridges (ADA 6240) |
$150 |
$245 |
$265 |
$425 |
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Full lower denture (ADA 5120) |
$320 |
$325 |
$375 |
$535 |
$260 |
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Inlays and onlays (ADA 2520) |
$115 |
$235 |
$125 |
$380 |
$95 |
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Partial dentures (ADA 5214) |
$354 |
$425 |
$380 |
$615 |
$280 |
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Re-cement bridges, crowns, inlays (ADA 2920) |
$6 |
$15 |
$15 |
$40 |
$10 |
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Relining dentures (ADA 5730) |
$18 |
$65 |
$60 |
$110 |
$45 |
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Repairs to full dentures, partial dentures, bridges (ADA 5510) |
$9 |
$35 |
$30 |
$70 |
$15 |
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Orthodontia Care |
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Child 24-month treatment fee (ADA 8670) |
$725 - $1,580 |
$2,250 |
$1,000 |
$1,700 |
75% |
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Adult 24-month treatment fee (ADA 8670) |
$725 - $1,580 |
$2,350 |
100% |
$2,100 |
75% |
**limited to children under age 16
Use the Dental Plan Cost Estimator to help you determine the best Dental Plan for you and your family based on your level of usage and associated costs.
Discontinued Plans
The State's contract with Oral Health Services expires at the end of 2007. This means that these plans will no longer be offered by the State for coverage beyond December 31, 2007.
If you are currently participating in one of the Oral Health Service (OHS) Plans, you may elect another plan during Annual Open Enrollment. If you do not actively elect a new plan and …
- are in the OHS Dental HMO, you will be moved to a Comp Benefits or United Dental HMO as shown on your Benefits Statement
- are in the OHS Dental PPO, you will be moved to the CompBenefits PPO.
New Coverage Levels for Some Plans
Coverage levels are changing for some plans. For example, the CIGNA Dental 4034 Plan will no longer offer Employee, Employee + 1, and Employee + 2 or more. Instead, it will offer four coverage levels (tiers): Employee, Employee + Spouse, Employee + Child(ren) and Employee + Spouse + Children (Family).
If you do not make an active election during Annual Open Enrollment, you will be automatically mapped as shown on your benefits statement. To elect a different coverage level than the one shown on your benefits statement, you must make an active election during Annual Open Enrollment.
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