Blue Access for Employers

2014 Fully-Insured Small Group Summary of Dental Benefits

To help you make an informed decision about your dental coverage, a Small Group Summary of Dental Benefits document is available for each of our fully-insured plans.  The summary describes key features such as:

  • Program basics
  • Covered services
  • Orthodontic services


All information represents an overview of coverage.  It’s not a complete list of what is covered or excluded.  Information is subject to change.  The full terms of coverage are located in the insurance policy.

Contact your Blue Cross and Blue Shield representative with questions at any time.


Blue Care Dental Small Group Benefit Summary


On the Exchange

Blue Care Dental 1A - (BPM $1,500 / $1,500)* pdf

Off the Exchange

Blue Care Dental 1A - (BPM $1,500 / $1,500) pdf
 

On the Exchange

Blue Care Dental 1B - (BPM $1,000 / $1,000)* pdf

Off the Exchange

Blue Care Dental 1B - (BPM $1,000 / $1,000) pdf
 

On the Exchange

Blue Care Dental 1C - (BPM $1,500 / $1,500)* pdf

Off the Exchange

Blue Care Dental 1C - (BPM $1,500 / $1,500) pdf
 

On the Exchange

Blue Care Dental 1D - (BPM $1,000 / $1,000)* pdf

Off the Exchange

Blue Care Dental 1D - (BPM $1,000 / $1,000) pdf
 

On the Exchange

Blue Care Dental 1E - (BPM $2,000 / $2,000)* pdf

Off the Exchange

Blue Care Dental 1E - (BPM $2,000 / $2,000) pdf
 

On the Exchange

Blue Care Dental 1F - (BPM $750 / $750)* pdf

Off the Exchange

Blue Care Dental 1F - (BPM $750 / $750) pdf
 

On the Exchange

Blue Care Dental Kids 1A - (Unlimited)** pdf

Off the Exchange

Blue Care Dental Kids 1A - (Unlimited) pdf
 

On the Exchange

Blue Care Dental Kids 1B - (Unlimited)** pdf

Off the Exchange

Blue Care Dental Kids 1B - (Unlimited) pdf
 
 


*Benefit Period Maximum: In Network / Out of Network

**Annual Maximum doesn’t apply for members under age 21

 

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