Blue Shield of California's dental plans provide your clients with a variety of rate and benefit options, most with no waiting periods.1 Your clients can select coverage for all employees – even those not enrolled in our health plans.
Give your small business clients a 10% specialty discount! Anytime you add dental and/or vision to a new or existing small business client's medical coverage, a 10% discount will be applied to the dental and/or vision premiums. Learn more.
This means one bill, one renewal, and one point of administration for all of your clients' Blue Shield business. And, your clients can access and manage all of their coverage information through Employer Connection. With just a few simple clicks members can print or order dental ID cards, track claims, view their annual account balance, or plan ahead with valuable treatment cost information.
A two-year initial rate guarantee for all new groups1 on their dental coverage, giving them added financial predictability for their budgeting and planning needs.
Our dental PPO plans offer flexibility and convenience with over 15,000 dentists and more than 46,000 access points2 in California. In addition, our national dental PPO network includes over 400,000 access points. With our dental HMO network, employees can choose from over 4,800 dentists in California and about 22,600 locations.
Blue Shield’s network use is 70.7%; our DPPO network average discount is 37.5%.
Mix and match – choose a variety of plan combinations that make sense for your clients.
3 DHMOs (must be purchased with medical)
2 DHMOs and 1 DPPO (must be purchased with medical)
2 DPPOs and 1 DHMO (2 DPPOs must have the same ortho benefit and must be purchased with medical)
Covered on the following two dental PPO plans:
SmileSM Deluxe 2000 50/2000/ No Ortho/MAC
SmileSM Deluxe Plus 2000 50/2000/Ortho/MAC
Oral cancer screening provided annually at no additional charge when using network providers.
Additional cleaning and treatment for pregnant women’s teeth to help prevent periodontal disease, which is linked to premature and low-birth-weight babies3.
Pediatric dental benefits, are included within our small business medical plans. PPO, HSA, and HMO medical plans and provide the same PPO dental coverage for pediatric dental benefits, but only PPO and HSA medical plans will offer coverage for pediatric dental benefits received from non-network providers, at non-network provider benefit levels. There is no coverage for non-network pediatric dental benefits in our HMO medical plans, except for emergencies. Dental and vision care are required essential health benefits (EHBs) under the Patient Protection and Affordable Care Act of 2010 (ACA) for children up to age 19. Learn more about the importance of early pediatric dental care. Learn more about the importance of pediatric dental care.
A 50% contribution is required for all dental4 plans except Voluntary Dental plans; no employer contribution required.
|Specialty acronyms||Definition||Additional clarification||Applicable Advantages|
|Member use of In-network providers can help reduce out of pocket costs for the member by reimbursing providers at a higher rate for the delivered services.|
Usual, Customary, Reasonable
|Meaning Blue Shield of California will only pay what we consider to be a usual, customary, and reasonable charge for any covered expenses incurred.||UCR plans can help members get maximum out-of-network providers and are good for groups with employees in remote areas.|
Maximum Allowable Charge
|This is a feature that will help our members save on out of pocket costs. Claims are paid according to the PPO fee schedule (maximum allowable charge). If a non-PPO provider is used, the member will pay a higher fee.||MAC plans can reduce premiums and are also advantageous when the majority of a group's providers are participating in the insurer's network. Groups that have not had dental coverage before can benefit from a MAC plan because premiums are typically lower.|
No Waiting Period
1 Excludes Dental Rollover plans which are closing March 31, 2019.
2 Access point(s) refers to all the locations where a member can “access” care. For example, a provider who treats patients at two different office locations represents two access points.
3 Dosanayoke, A., et al. “Periodontal Pathogens and Gestational Diabetes Mellitus.” Journal of Dental Research. April 1, 2008.
4 The Smile Basic Voluntary PPO plan has a 12-month waiting period for major services.
© Blue Shield of California 1999-2017. All rights reserved. Blue Shield of California is an independent member of the Blue Shield Association.
Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Health plans are offered by Blue Shield of California.