Voluntary Dental is a great way to provide your employees with easy access to dental care coverage. As implied by the name, the plan is entirely voluntary, meaning that your employees decide whether or not they want to participate. And because the program is voluntary, there are no participation or contribution requirements.
To get started, all you have to do is choose the benefit plan option that is best for your company and then enroll in the plan as a group. You will be billed each month for the entire premium, and then deduct the appropriate premium for each participating employee's dental coverage premium from their paycheck.
The PPO Advantage
Voluntary Dental is a Preferred Provider Organization (PPO) product, which means that in order to receive the most in benefit payments, members should choose their dentist from our PPO network. We have PPO agreements with dentists throughout Idaho so that our members are not billed more than an amount that Blue Cross of Idaho has determined to be the maximum allowance for an eligible service.
When dental services are provided by a contracting (in-network) dentist, the member is only responsible for any deductible, coinsurance, copayment and noncovered amounts.
With Voluntary Dental, you can choose a $25 in-network and $50 out-of-network per person deductible or a $50 in-network and $75 out-of-network per person deductible. Both options have a maximum of three benefit period deductibles per family. The deductible does not apply to in-network preventive covered services.
Benefit Period Maximum Amount
Voluntary Dental provides coverage for up to $1,000, $1,250 or $1,500 annually depending upon the option chosen. The maximum benefit amount is per member, per benefit period, which is the twelve months following your group's effective date.
Preventive Dental Benefits
Voluntary Dental pays 100% of the maximum allowance for in-network services with a $20, $25 or $30 copayment depending upon the option chosen. The deductible does not apply to in-network preventive services. Out-of-network services are paid at 40-70% of the maximum allowance after the deductible has been satisfied.
Available benefits include one oral exam every six months, x-rays, cleanings and fluoride treatments. Certain benefits are only available to dependent children with age maximums.
Basic Care Benefits
Voluntary Dental pays 40-80% of the maximum allowance for in-network services and 30-50% of the maximum allowance for out-of-network services. Basic care services are eligible for payment after the benefit period deductible and a six-month waiting period is met.
Basic care benefits cover frequently covered services such as sealants, fillings and simple extractions.
Major Care Benefits
Voluntary Dental pays up to 50% of the maximum allowance for in-network services and 20-40% of the maximum allowance for out-of-network services, depending on the plan chosen. Major care services are eligible for payment after the benefit period deductible and a 12-month waiting period are met.
Major care benefits of Voluntary Dental include prosthetic and restorative treatments such as crowns, bridgework and root canal therapy.
Orthodontia Benefits (Optional)
As an option to your group plan, you may add orthodontia benefits. These benefits are available to enrolled dependent children. The orthodontic option pays 50% of the maximum allowance for covered services with a maximum lifetime benefit of up to $1,000, $1,250 or $1,500 depending on the option chosen, after a 24 month waiting period has been met. The maximum paid per benefit period is $500.
This outline is a brief description of the coverage issued to the group. This is not a contract. The policy describes in detail the rights and obligations of both the group and Blue Cross of Idaho under the group policy. It is important that you read the policy carefully. The benefits of the policy are governed primarily by Idaho law.