The following table provides a general overview of the benefits available under the state-sponsored dental plans. Consult each plan’s brochure and evidence of coverage booklet for detailed information and plan limitations.
$75 per person up to $200 annual maximum per family for PPO network dentists.
$2,000 for retiree $2,000 per eligible dependent when PPO network dentists are used., $2,000 per eligible dependent when PPO network dentists are used.
$1,000 for retiree, $1,000 per eligible dependent when non-PPO network dentists are used.