Dental Insurance

The High PPO Plan offered by Standard through the Ameritas dental network has an extensive nationwide dental network with numerous dentists, including Specialists. This plan also includes an out-of-network benefit and reimburses at one of the highest usual and customary percentiles, which means less out-of-pocket cost to you. If you utilize a “participating” network dentist your savings are even greater because the participating network dentist must charge a negotiated contract rate.

The annual maximum benefit is: $1,500 per person in-network and $1,000 per person out-of-network. There is a $50 annual deductible (waived on Preventive) per person, maximum three family members, which satisfies both your in-network and out-of-network deductible. If you reach your annual maximum, you will also be eligible to receive additional services at discounted rates.

The High PPO plan offers a unique feature, MAX BUILDER, that allows members to carry over some of their benefit into the next plan year based on plan usage:

1. Member must go to the dentist and submit at least one dental claim during the plan year
2. Dental benefits paid during the plan year were $500 or less 

If both 1 and 2 are met, $250 carries over and is added to the next year’s maximum. The maximum carryover that can accumulate is $1,000. As an added benefit, if you meet 1 & 2, and if you receive services from a Participating Dentist during the year, you will receive an additional $100 for a total carry over for the year of $350. 

Note: if you do not submit a dental claim during the plan year the feature resets.

2013 PPO Plan Rates
(Deductions for Domestic Partner and/or Over-Age Dependent (Child age 26-29 on 01/01/12) coverage will be split between Pre- and After-Tax deductions.

Contact Information
Member Services, 800-547-9515
Visit The Standard Dental

Important Forms
PPO Dental Claim Form (PDF)

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