Choice Stories

February 3, 2021

CaliforniaChoice Dental Coverage Comparison: SmileSaver Dental HMO and Ameritas Dental PPO Options

Born and raised in California, CaliforniaChoice embraces the unique needs of our members. That's why our employee benefits program includes eight different health plans in a single program – plus options for Dental, Vision, Chiropractic & Acupuncture, and Life and AD&D. We know what's important to one person may not be important to another. So, we give employees the ability to choose what's right for their individual or family health care needs.

The CaliforniaChoice plan comparison series takes a closer look at each of the plans in our program and the added options. This comparison snapshot highlights the key benefits of our Dental offerings, specifically SmileSaver Dental HMO and Ameritas Dental PPO.

The tables below show the Dental plans available from SmileSaver and Ameritas.

Your SmileSaver HMO options:

Notes: Copays listed are for services performed by general dentists. Please review the Explanation of Coverage (EOC) for specialist copays. For crowns, the extra cost of high noble metal (gold, etc.) may be charged when used, not to exceed actual laboratory costs of metal.

These are two of your four Ameritas PPO options:

Notes: Please refer to the plan Certificate for specific plan details. Orthodontia (with a 12-month wait and a Lifetime Maximum of $1,000) is included for children starting treatment before their 19th birthday for the PPO 3500. A 12-month Waiting Period applies to Endo/Perio; Waiting Period waived for groups with 10+ employees and 12 months of continuous, uninterrupted Dental coverage on previous plan. For PPO 3500, submit one covered Dental claim each year and the Basic Procedures will advance to the 90% level the following year and 100% on the third year. The Annual Maximum is a Dental/Vision combined benefit; a maximum of which $100 can be applied toward eye care expenses. The Fusion Vision Reimbursement benefit is an added feature of PPO 3500; it offers a $100 annual maximum per calendar year to spend at any eye care provider.

These are the other two Ameritas PPO options:

Notes: Please refer to the plan Certificate for specific plan details. Orthodontia (with a 12-month wait and a Lifetime Maximum of $1,000) is included for children starting treatment before their 19th birthday for the PPO 4000 and 5000 plans. A 12-month Waiting Period applies to Endo/Perio; Waiting Period waived for groups with 10+ employees and 12 months of continuous, uninterrupted Dental coverage on previous plan. For PPO 4000 and 5000, submit one covered Dental claim each year and the Basic Procedures will advance to the 90% level the following year and 100% on the third year. The Annual Maximum is a Dental/Vision combined benefit; a maximum of which $100 can be applied toward eye care expenses. The Fusion Vision Reimbursement benefit is an added feature of PPO 4000 and 5000; it offers a $100 annual maximum per calendar year to spend at any eye care provider.

Dental Rewards® by Ameritas are available to members enrolled in PPO 3500, 4000, and 5000 plans who visit the dentist and use only a portion of their annual maximum benefit in a year. Members can earn additional money toward their next year’s annual maximum benefit. For PPO 4000 and 5000 members, Ameritas Extras include LASIK and Hearing Care coverage. Refer to the plan enrollment materials for details.

For additional information about CaliforniaChoice and available Dental options, talk with your employee benefits agent or health insurance broker. If you don’t already have one, we can help you find one here.

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