Closed Dental PPO Plans - January 1, 2021: for renewing groups only

Closed Dental Plans - January 1, 2021: for renewing groups only

Plan Name Benefit Summaries Disclosures

SmileSM Basic 75/1000/No Ortho/Mac

English 
Spanish

 English
SmileSM Value 50/1500/No Ortho/MAC

English
Spanish

 English
SmileSM 50/1500/No Ortho/Mac

English
Spanish

 English
SmileSM Plus 50/1500/Ortho/Mac

English
Spanish

 English
SmileSM Plus Gold 50/1500/Ortho/U85

English
Spanish

 English
SmileSM Deluxe 2000 50/2000/No Ortho/MAC

English
Spanish

 English
SmileSM Deluxe 50/1500/Ortho/MAC

English
Spanish

 English
SmileSM Deluxe Plus 2000 50/2000/Ortho/MAC

English
Spanish

 English
SmileSM Deluxe Gold 50/1500/Ortho/U85

English
Spanish

 English
Ultimate Dental PPO for Small Business 50/2000/No Ortho/MAC

English
Spanish

 English
Ultimate Dental Plus PPO for Small Business 50/2000/Ortho/MAC

English
Spanish

 English

SmileSM Basic Voluntary 75/1000/No Ortho/MAC

English
Spanish

 English
SmileSM Basic Voluntary 75/1000/No Ortho/MAC - NWP

English
Spanish

 English
SmileSM In-Network Only Dental Plan 50/2500/Endo-Perio 80%/Ortho

English
Spanish

 English
SmileSM In-Network Only Dental Plan 50/2500/Endo-Perio 80%/No Ortho

English
Spanish

 English
SmileSM In-Network Only Dental Voluntary Plan 50/2500/Endo-Perio 50%/Ortho

English
Spanish

 English
SmileSM In-Network Only Dental Voluntary Plan 50/2500/Endo-Perio 50%/No Ortho

English
Spanish

 English
SmileSM In-Network Only Dental Plan 50/1500/Endo-Perio 80%/Ortho

English
Spanish

 English
SmileSM In-Network Only Dental Plan 50/1500/Endo-Perio 80%/No Ortho

English
Spanish

 English
SmileSM INO Dental Voluntary Plan 50/1500/EndoPerio 50%/Ortho (NWP)

English
Spanish

 English
SmileSM INO Dental Voluntary Plan 50/1500/EndoPerio 50%/No Ortho (NWP)

English
Spanish

 English
SmileSM INO Dental Voluntary Plan 50/1500/EndoPerio 50%/Ortho

English
Spanish

 English
SmileSM INO Dental Voluntary Plan 50/1500/EndoPerio 50%/No Ortho

English
Spanish

 English
SmileSM INO Dental Voluntary Plan 50/2500/EndoPerio 50%/Ortho/NWP

English
Spanish

 English
SmileSM INO Dental Voluntary Plan 50/2500/EndoPerio 50%/No Ortho/NWP

English
Spanish

 English

Contact Us

  • Producer Services (800) 559-5905

    Employer Services (800) 325-5166

  • Blue Shield of California

    PO Box 272540

    Chico, CA 95927-2540

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Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Health plans are offered by Blue Shield of California.