It’s easy to find the
right dental plan
Plans come and go, but finding the right
dental coverage for your clients will make
everyone happy
55948CAEENABC 9/15
Choosing a new dental plan that’s right for their employees can be a tough decision for your clients. But it doesn’t have
to be with your help and one of our new, simplified and flexible dental plans. To make things even easier, we’ve created
these charts to help you find a new dental plan that most closely matches our previous dental portfolio.
Out-of-network reimbursement
Annual deductible
Annual maximum
Diagnostic and preventive services
Minor restorative services
Oral surgery services
Endodontic services
Periodontic services
Prosthodontic services
Dental implants/posterior composites
Orthodontia
Waiting periods
Out-of-network reimbursement
Annual deductible
Annual maximum
Diagnostic and preventive services
Minor restorative services
Oral surgery services
Endodontic services
Periodontic services
Prosthodontic services
Dental implants/posterior composites
Orthodontia
Waiting periods
Out-of-network reimbursement
Annual deductible
Annual maximum
Diagnostic and preventive services
Minor restorative services
Oral surgery services
Endodontic services
Periodontic services
Prosthodontic services
Dental implants/posterior composites
Orthodontia
Waiting periods
Dental Blue Silver 100-80
In-network
Out-of-network
80th percentile
$50/$150
$1,000
100%
80%
80%
60%
50%
50%
50%
50%
50%
50%
50%
50%
Not covered
50% up to $1,000
Classic Complete CA-2A (2-50)
In-network
Out-of-network
80th percentile
$50/$150
$1,000
100%
80%
80%
60%
50%
50%
50%
50%
50%
50%
50%
50%
Covered
Not covered
No waiting periods
Classic Dental Plan CA-2Q (10-50)
In-network
Out-of-network
80th percentile
$50/$150
$1,500
100%
100%
80%
80%
80%
80%
80%
80%
80%
80%
50%
50%
Covered
50% to $1,500 adult and children
Dental Blue Silver Plus 100-80
In-network
Out-of-network
80th percentile
$50/$150
$1,500
100%
80%
80%
60%
80%
60%
80%
60%
80%
60%
50%
50%
Not covered
Not covered
Classic Complete CA-2G (2-50)
In-network
Out-of-network
80th percentile
$50/$150
$1,500
100%
80%
80%
60%
80%
60%
80%
60%
80%
60%
50%
50%
Not covered
Not covered
No waiting periods
Classic Complete CA-2S (2-50)
In-network
Out-of-network
80th percentile
$50/$150
$1,500
100%
80%
80%
60%
80%
60%
80%
60%
80%
60%
50%
50%
Covered
Not covered
Dental Blue Gold 100-80
In-network
Out-of-network
80th percentile
$50/$150
$1,500
100%
80%
80%
60%
50%
50%
50%
50%
50%
50%
50%
50%
Not covered
50% up to $1,000
Classic Complete CA-2S (2-50)
In-network
Out-of-network
80th percentile
$50/$150
$1,500
100%
80%
80%
60%
80%
60%
80%
60%
80%
60%
50%
50%
Covered
Not covered
No waiting periods
Classic Dental Plan CA-2P (10-50)
In-network
Out-of-network
90th percentile
$50/$150
$1,500
100%
100%
80%
80%
80%
80%
80%
80%
80%
80%
50%
50%
Covered
50% to $1,500 children ages 8 to 18
Out-of-network reimbursement
Annual deductible
Annual maximum
Diagnostic and preventive services
Minor restorative services
Oral surgery services
Endodontics
Periodontic services
Prosthodontic services
Dental implants/posterior composites
Orthodontia
Waiting periods
Out-of-network reimbursement
Annual deductible
Annual maximum
Diagnostic and preventive services
Minor restorative services
Oral surgery services
Endodontic services
Periodontic services
Prosthodontic services
Dental implants/posterior composites
Orthodontia
Waiting periods
Out-of-network reimbursement
Annual deductible
Annual maximum
Diagnostic and preventive services
Minor restorative services
Oral surgery services
Endodontic services
Periodontic services
Prosthodontic services
Dental implants/posterior composites
Orthodontia
Waiting periods
Dental Blue Gold Plus 100-80
In-network
Out-of-network
80th percentile
$50/$150
$1,500
100%
80%
80%
60%
50%
60%
50%
60%
50%
60%
50%
50%
Not covered
50% up to $1,000
Classic Complete CA-2S (2-50)
In-network
Out-of-network
80th percentile
$50/$150
$1,500
100%
80%
80%
60%
80%
60%
80%
60%
80%
60%
50%
50%
Covered
Not covered
No waiting periods
Classic Dental Plan CA-2P (10-50)
In-network
Out-of-network
90th percentile
$50/$150
$1,500
100%
100%
80%
80%
80%
80%
80%
80%
80%
80%
50%
50%
Covered
50% to $1,500 children ages 8 to 18
Dental Blue Platinum 100-80
In-network
Out-of-network
80th percentile
$50/$150
$2,000
100%
100%
90%
80%
60%
50%
60%
50%
60%
50%
60%
50%
Not covered
50% up to $1,500
Classic Dental Plan CA-3A (2-50)
In-network
Out-of-network
80th percentile
$50/$150
$2,000
100%
100%
90%
80%
90%
80%
90%
80%
90%
80%
60%
50%
Covered
Not covered
No waiting periods
Classic Dental Plan CA-3B (10-50)
In-network
Out-of-network
90th percentile
$50/$150
$2,000
100%
100%
90%
80%
90%
80%
90%
80%
90%
80%
60%
50%
Covered
50% up to $2,000 adult and children
Dental Blue Platinum Plus 100-80
In-network
Out-of-network
80th percentile
$50/$150
$2,000
100%
100%
90%
80%
90%
80%
90%
80%
90%
80%
60%
50%
Not covered
50% up to $1,500
Classic Dental Plan CA-3A (2-50)
In-network
Out-of-network
80th percentile
$50/$150
$2,000
100%
100%
90%
80%
90%
80%
90%
80%
90%
80%
60%
50%
Covered
Not covered
No waiting periods
Classic Dental Plan CA-3B (10-50)
In-network
Out-of-network
90th percentile
$50/$150
$2,000
100%
100%
90%
80%
90%
80%
90%
80%
90%
80%
60%
50%
Covered
50% up to $2000 Adult & Children
Out-of-network reimbursement
Annual deductible
Annual maximum
Diagnostic and preventive services
Minor restorative services
Oral surgery services
Endodontic services
Periodontic services
Prosthodontic services
Dental implants/posterior composites
Orthodontia
Waiting periods
Out-of-network reimbursement
Annual deductible
Annual maximum
Diagnostic and preventive services
Minor restorative services
Oral surgery services
Endodontic services
Periodontic services
Prosthodontic services
Dental implants/posterior composites
Orthodontia
Waiting periods
Out-of-network reimbursement
Annual deductible
Annual maximum
Diagnostic and preventive services
Minor restorative services
Oral surgery services
Endodontic services
Periodontic services
Prosthodontic services
Dental implants/posterior composites
Orthodontia
Waiting periods
Basic Option Dental PPO
In-network
Out-of-network
MAC
$75/$225
$1,000
100%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
50%
Not covered
Not covered
12-month waiting period for periodontic
services and prosthodontic services
Classic Complete CA-2A (2-50)
Classic Dental Plan CA-5A (10-50)
In-network
Out-of-network
In-network
Out-of-network
80th percentile
MAC
$50/$150
$50/$150
$1,000
$1,500
100%
80%
100%
80%
80%
60%
80%
60%
50%
50%
80%
60%
50%
50%
80%
60%
50%
50%
80%
60%
50%
50%
50%
50%
Covered
Covered
Not covered
50% to $1,500 children ages 8 to 18
No waiting periods
Standard Option
In-network
Out-of-network
MAC
$50/$150
$1,000
100%
80%
80%
80%
50%
50%
50%
50%
50%
50%
50%
50%
Not covered
Not covered
12-month waiting period for periodontic
services and prosthodontic services
Classic Complete CA-2G (2-50)
Classic Complete CA-2S (2-50)
In-network
Out-of-network
In-network
Out-of-network
80th percentile
80th percentile
$50/$150
$50/$150
$1,500
$1,500
100%
80%
100%
80%
80%
60%
80%
60%
80%
60%
80%
60%
80%
60%
80%
60%
80%
60%
80%
60%
50%
50%
50%
50%
Not covered
Covered
Not covered
Not covered
No waiting periods
High Option
In-network
Out-of-network
MAC
$50/$150
$2,000
100%
80%
80%
80%
80%
80%
80%
80%
50%
50%
50%
50%
Not covered
50% up to $1,500 children ages 8 to 18
12-month waiting period for periodontic
services and prosthodontic services
Classic Dental Plan CA-3A (2-50)
Classic Dental Plan CA-3B (10-50)
In-network
Out-of-network
In-network
Out-of-network
80th percentile
90th percentile
$50/$150
$50/$150
$2,000
$2,000
100%
100%
100%
100%
90%
80%
90%
80%
90%
80%
90%
80%
90%
80%
90%
80%
90%
80%
90%
80%
60%
50%
60%
50%
Covered
Covered
Not covered
50% up to $2,000 adult and children
No waiting periods
Want to know more or get a quote
on a new dental plan?
Life products underwritten by Anthem Blue Cross Life and Health Insurance Company. Anthem Blue Cross is the trade name of Blue Cross of California.
Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a
registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.
Dental, vision and life plans are easy to quote
and easy to add. So call 1-877-567-1802 or
email [email protected].