With Blue Dental PPO SG plans for all ages, employees have different coverage levels for some services depending on whether they go to in-network or out-of-network dentists. They'll get the highest coverage and save the most money when they go to PPO dentists. If they see a dentist who's outside the PPO network, they can still save money by choosing Blue Par Select dentists.

Here are some other things you need to know about these plans:

  • The annual out-of-pocket maximum for members under age 19 is $350 for one member, $700 for two or more members.
  • You can add Class IV (orthodontic) coverage to all of these plans.
Blue Dental PPO employer-paid plan options breakdown
Employer-paid
plan options
Blue Dental PPO
100/80/50 (80/50/50) SG
Blue Dental PPO
100/80/50 (50/50/50) SG
Blue Dental PPO
80/50/50 (50/50/50) SG
Class I In network: Covered 100% Out of network:Covered 80% In network: Covered 100% Out of network: Covered 50% In network: Covered 80% Out of network: Covered 50%
Class II In network: Covered 80% Out of network:Covered 50% In network: Covered 80% Out of network:Covered 50% In network: Covered 50% Out of network:Covered 50%
Class III In network: Covered 50% Out of network:Covered 50% In network: Covered 50% Out of network:Covered 50% In network: Covered 50% Out of network:Covered 50%
Deductible for Class II and Class III services
(individual/family)
In network: $25/$75 Out of network: $50/$150 In network: $25/$75 Out of network: $50/$150 In network: $25/$75 Out of network: $50/$150
Annual maximum (for members age 19+) In network: $1,250 Out of network: $800* This plan has two annual maximum options:$1,500 or $1,000 This plan has two annual maximum options:In network: $1,000 or $800 Out of network: $800*
Blue Dental PPO voluntary plan options breakdown
Voluntary plan options Blue Dental PPO
100/80/50 (80/50/50) V SG
Blue Dental PPO
80/50/50 (50/50/50) V SG
Class I In network: Covered 100% Out of network: 80% In network: Covered 80% Out of network: Covered 50%
Class II In network: Covered 80% Out of network: Covered 50% In network: Covered 50% Out of network: Covered 50%
Class III In network: Covered 50% Out of network: Covered 50% In network: Covered 50% Out of network: Covered 50%
Deductible for Class II and Class III services
(individual/family)
In network: $25/$75 Out of network: $50/$150 In network: $25/$75 Out of network: $50/$150
Annual maximum (for members age 19+) This plan has two annual maximum options: In network: $1,250* or $1,000* or Out of network: $800* In network: $1,000* Out of network: $800*

*No more than $800 of the annual maximum your insurance pays can be used for services provided by non-PPO dentists.