A Lower Cost Plan: SimpleChoice® from Washington Dental Service
SimpleChoice Plan Options
| Groups with 5 - 99 Subscribers |
Co-Insurance Options
SimpleChoice Network |
Calendar Year Deductible Option
(Individual/Family) Waived for Class I |
Calendar Year Maximum Options |
Rider Options |
80/80/50 100/80/50 100/100/50
|
$0/$0 $25/$75 $50/$150 $75/$225
|
$1,000 $1,500 $2,000
|
Orthodontia: Adult and Children Only (Minimum Group Size 10) $1,000 $1,500 $2,000
|
SimpleChoice is a fee-for-service plan. If you choose to see a Delta Dental Premier or PPO dentist who is not part of the SimpleChoice network, claims payments will be basedon the SimpleChoice fee schedule at the appropriate percentage levels. Nonparticipating dentists are paid based on actual charges or WDS's SimpleChoice fees, whicher is less. Employees are responsible for paying any remaining balance.
Washington Dental Service Benefit Highlights:
- Cover up to four periodontal cleanings a year under certain qualifying periodontal circumstance.
- Periodontal cleanings are covered under class I.
- Endodontic and Non-Surgical Periodontics are covered under class II.
- Fluoride and sealant coverage for both adults and children.
- Deductible waived for class I services.
- No "missing tooth clause" or pre-existing conditions.
- Optional waiting period available (6 month wait for class II and 12 month wait for class III).
- TMJ coverage included - $1,000 annual maximum and $5,000 lifetime maximum.
- Implant coverage included.
- Dependents are eligible for benefits through age 25.
Underwriting Guidelines
Eligibility
- Coverage is available to employees working a minimum of 20 hours per week or 80 hours per month.
Contributions
- Employer must contribute at least 50 percent of the employee premium.
- No employer contribution is required toward the dependent premium.
Participation
- Employee participation for groups with 5 to 9 enrolled subscribers is 100 percent of all eligible employees or tied to the company's medical plan.
- Dependent participation for groups with 5 to 9 enrolled subscribers is 100 percent of all eligible dependents.
- Employee participation for groups with 10 to 99 enrolled subscribers is 75 percent enrollment of all eligible employees.
- Dependent participation for groups with 10 to 99 enrolled subscribers is 50 percent of all eligible dependents.
Rate Guarantee
Click here for the PDF version.Please contact your Sales Executive on groups with 100 or more enrolled subscribers for plan options.