Dental
The OPEH&W Health Plan’s Plan Year runs from July 1, 2019 through June 30, 2020.
Rates and Coverage details are per plan year unless stated otherwise and are valid July 1, 2019 through June 30, 2020.
Rates shown are for Active Employees.

On this Page
Resources
Rates
Coverage Details
Coverage Highlights
Preventive & Diagnostic Benefits
Basic Services
Major Services
Orthodontic Benefits
Video


Resources
Coverage Highlight (One Page) Download
Dental Out-of-Network Claim Form Download
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Premium Rates
Monthly for Active Employees
Member      $42.36
Child      $22.82
Children      $36.28
Spouse      $53.36
Spouse & Child      $76.18
Spouse & Children      $89.64
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Coverage Details
Vendor     BlueCross BlueShield of Oklahoma
Website     www.bcbsok.com
Member Support     888.381.9727
Network     Dental Network of American (DNoA)
Network Support     800.972.7565
Provider Search     Search
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Coverage Highlights
Plan Paid Maximum     $1,500
Deductible     $50
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Preventive & Diagnostic Services
Co-Insurance     0%
How it Works     Plan pays 100% of covered services 2 times per plan year, not subject to deductible.
Covered Services     Includes but not limited to: Cleaning, Polishing, Bite-Wings X-Rays & Prophylaxis
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Basic Services
Co-Insurance     20%
How it Works     After meeting deductible member pays 20% co-insurance of covered Basic Services until the Plan Paid Maximum has been met, after which member pays 100% of claims costs for the remainder of the plan year.
Covered Services     Includes but not limited to: Fillings, Simple Extractions, Surgical Removal of Teeth & Root Canals
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Major Services
Co-Insurance     50%
How it Works     After meeting deductible member pays 50% co-insurance of covered Major Services until the Plan Year Plan Paid Maximum has been met, after which member pays 100% of claims costs for the remainder of the plan year.
Covered Services     Includes but not limited to: Crowns, Full or Partial Dentures, Bridge Repairs & Occlusal Guards
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Orthodontic Services
Co-Insurance     50%
How it Works     Member pays 50% co-insurance of covered Orthodontic Services for Dependent Children up to age 26, until the Lifetime Maximum of $1,500 has been met, after which member pays 100% of claims costs.
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Video
Videos are best viewed in full screen mode. To enter full screen mode, first hit play, then click the icon in the lower right of the video pane which looks like a square with gaps in each side
Having trouble viewing in-page videos, then use the following direct YouTube link
Dental Benefits http://youtu.be/f_dAPbr-wz4
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