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Dental Coverage
Small Businesses (1 to 100)

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. Dental PPO and In-Network Only (INO) plans* offer an oral cancer screening benefit covered at 100% to help detect and treat oral cancer early when the opportunity for a cure is greater.

All of our group plans offer streamlined administration: this means one bill, one renewal and one point of administration for all of your clients' Blue Shield business. Employers can access all of their coverage through Employer Connection for information and management of all their plans.

Dental coverage is available with or without Blue Shield medical coverage. Neither underwriting nor a DE-9C is required for dental coverage when written without Blue Shield medical coverage.
Large Dental PPO and HMO networks:

  • Expanded dental PPO network now ranks in the top 5 in the state with more than 51,000 locations
  • Second largest dental HMO network in California
Dental Smile Rollover Rewards program
Now, your clients and their employees have another way to achieve savings while maintaining their oral health through the Dental Smile Rollover Rewards program. It's automatically a part of their dental PPO plan or dental INO plan.

All employees need to do is visit their dentist at least once a year and if, at the end of the year, their paid dental claims are below the claim threshold, they’ll receive their rewards. And if they see a dentist in their PPO network, versus an out-of-network dentist, they’ll receive an additional boost to their rewards amount.

The reward amount is based on the dental plan's calendar-year maximum and the program’s annual claim threshold for your employee plan(s). Any rewards employees earns will rollover in the form of calendar-year maximum funds and raise their calendar-year maximum for the next benefit year.

Download (PDF, 55KB) the Smile Dental Rollover Reward program flier for more details.
Manage your dental plan online
Whether employees are enrolled in a small business dental PPO, INO or HMO plan, or are a member of a pediatric dental plan, access to their dental plan information has never been easier.  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.

Download (PDF, 383KB) the Guide to Managing Your Dental Plan Online flier for more details.
Pediatric dental benefits are included and embedded with medical plans
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.

Download (PDF, 92KB) the Pediatric Dental and Vision FAQs
Caries Management by Risk Assessment
Caries Management by Risk Assessment (CAMBRA) is an evaluation of a patient's risk level for the caries infection, or tooth decay, and is a benefit of every child's Blue Shield dental coverage. (Note: pediatric embedded dental plans do not offer Caries Risk Management benefits as it exceeds the defined “benchmark” set by Covered California.)

Download the Caries Risk Management Assessment flier:

Download - English (PDF, 78KB)   |    Download - Spanish (PDF, 78KB)
Blue Shield Dental PPO Plans
Advantages of dental PPO Smile plans
  • Large provider network with more than 338,000 nationwide providers, including over 51,000 in California2
  • Orthodontic coverage options for children and adults, with up to a $1,000 annual orthodontic benefit per member
  • Plan options that include dental implant benefits
  • Two Ultimate Dental PPO plans with 100/90/60 $2,000 coinsurance plans
  • Enhanced dental benefits for pregnant women
In-Network Only (INO) Dental Plans
The INO network includes all the same providers as the dental PPO network.2 There is no coverage for services received outside of this network. Employers select from these options:
  • Voluntary or contributory
  • $1,500 or $2,500 calendar year benefit maximum
  • Endodontics and periodontics (surgical or complex) coverage level (50% or 80% co-insurance level)
  • Orthodontia coverage (include or exclude)
Advantages of the dental INO plans
  • A choice of options to help your clients protect their employees' oral health and their bottom line
  • Orthodontic coverage options for children and adults, with up to a $1,000 annual orthodontic benefit per member
  • Enhanced dental benefits for pregnant women
Blue Shield Dental HMO Plans
For your cost-conscious clients, offer them one or more of four dental HMO plans, including one voluntary DHMO plan. All plans offer a full range of dental services with affordable, member-friendly fixed member copayments.
Advantages of the dental HMO plans
  • No plan deductibles or calendar-year maximums
  • No charge for diagnostic and preventive services
  • Access to more than 24,000 dental providers in California2
  • Orthodontic coverage for children and adults
Participation Requirements
There is a 65% employee participation requirement when written alongside the Blue Shield Off-Exchange medical plans. No participation requirement for groups selecting a Voluntary Dental plan.
Contribution Requirements
A 50% contribution is required for all dental1 plans except Voluntary Dental plans; no employer contribution required.
Plan Selection Options
Dual Option Dental allows your clients to provide employees a choice between any two dental plans, including voluntary plans.

Triple Option Dental allows your clients the following selection capabilities:
  • 3 HMOs
  • 2 HMOs and 1 PPO
  • 2 HMOs and 1 INO
  • 2 PPOs and 1 HMO4
  • 2 INOs and 1 HMO4
  • 1 PPO, 1 INO and 1 HMO4
See the Value
Help your clients see the value that dental coverage can bring them in the infographic, Why You Need Group Dental Coverage.
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1. The Smile Basic Voluntary PPO plan and Voluntary INO plans have a 12-month waiting period for major services. Starting in 2014, new groups selecting our voluntary PPO or INO plans, who have had coverage for 12 months or more with major services, will have the waiting period of 12 months waived.
2. Underwritten by Blue Shield of California Life & Health Insurance Company (Blue Shield Life) and pending regulatory approval.
3. Dental providers in and out of California are available through a contracted dental plan administrator.
4. Triple option with 2 PPOs and 1 HMO; 2 INOs and 1 HMO; or 1 PPO, 1 INO and 1 HMO must be purchased with Blue Shield medical coverage.
Broker Resources
Benefit summaries
Evidence of Coverage
Dental brochure
Dental Smile rollover rewards program
Dental networks at a glance
Competetive highlights
Sales resources and collateral
Help your clients see the value in dental coverage
Pediatric dental and vision coverage
TRUSTe Privacy Certification