Dental

Keeping you smiling

Your Dental Plan encourages good dental health by helping you pay for most diagnostic and preventive dental care before serious treatment is necessary.

The Dental Plan is provided through Blue Cross Blue Shield (BCBS) but it is not a network-based plan — you have the freedom to select the dental providers of your choice. You pay the same deductible and coinsurance regardless of the provider you choose for your care.

Here’s how it works

SERVICE COST TO YOU

Annual Deductible

(waived for diagnostic and preventive services)

$50 per individual;

$150 per family

Annual Maximum
(applies to all services except Orthodontia and TMJ)

$2,000 per individual

Diagnostic and Preventive Services

No cost to you

Basic Restorative Services

Plan pays 80% after deductible is met

Major Restorative Services

Plan pays 50% after deductible is met

Emergency Treatment
(when necessary to ease pain or discomfort, but not treatment to cure the pain or discomfort, such as extractions or permanent fillings)

No cost to you

Orthodontia Services
(coverage is limited to dependent children)

Plan pays 50% after deductible is met
($2,500 lifetime maximum per child)

Non-Surgical Treatment of Temporomandibular Joint (TMJ) Disorders

Plan pays 80% after deductible is met
($1,000 lifetime maximum per individual)

For more information on your dental plan and the services covered, call 888-868-5527 or visit the BCBS NC website.

Monthly premiums

DENTAL PLAN

Employee Only

$6

Employee + Spouse/Domestic Partner

$22

Employee + Child(ren)

$22

Employee + Family

$38

Downloads

Summary of coverage (2020)

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