Dental Insurance for a Healthy Mouth

With quality dental insurance benefits, we give CCA member employees something to smile about. We are proud to offer employees of all different participation levels with 2 cost-effective, flexible benefit dental plans through Unum® that have been designed to meet each employee's needs. The 2 PPO plans offer a $5,000 ANNUAL MAX.

This is a summary of benefits for your PPO plan. All deductibles, plan maximums, and service specific maximums (dollar and occurrence) cross accumulate between in and out of network. PPO plan benefits are identical with the exception of the Out of Network Reimbursement.



GROUP DENTAL INSURANCE

Coverage Effective Date: October 1, 2020 Rate Guarantee: 24 Months

Employees choose
one plan option
Option 1: HIGH PPO
Monthly Premiums
Option 2: LOW MAC
Monthly Premiums
Employee $50.31 $34.73
Employee & 1 Dependent $83.73 $57.87
Employee & 2+ Dependents $135.18 $96.05

PLAN DESCRIPTION

Option 1 : Passive PPO Option 2 : Passive MAC
IN/OUT OF NETWORK IN/OUT OF NETWORK
Deductible $50 ANNUAL
MAXIMUM 3 PER FAMILY
Waived for Class A
(Applies to Class B & C Services)
$50 ANNUAL
MAXIMUM 3 PER FAMILY
Waived for Class A
(Applies to Class B & C Services)
Benefit Year Maximum (Applied per calendar year) $5,000
(Applies to Class A, B & C Services, if applicable)
$5,000
(Applies to Class A, B & C Services, if applicable)
Orthodontia Maximum Lifetime: $1,000
Annual: NONE
(Applies to Class D Services)
Lifetime: $1,000
Annual: NONE
(Applies to Class D Services)
Co-insurance
Class A
Class B
Class C
Class D
100%
80%
50%
50%
100%
80%
50%
50%
Reimbursem-ents In Network: Fee Schedule
Out of Network: 90th percentile
In Network: Fee Schedule
Out of Network: Services are reimbursed from the IN
NETWORK schedule

PLAN SERVICES

Option 1: Passive PPO Option 2: Passive MAC
Class A
Preventative Services
  • Waiting Period: None
  • Routine exams (2 per 12 months)
  • Prophylaxis (2 per 12 months) (1 additional
    cleaning or periodontal maintenance per 12
    months if member is in 2nd or 3rd trimester of
    pregnancy)
  • Bitewing x-rays (max 4 films:1 per 12 months)
  • Fluoride to age 16 (1 per 12 months)
  • Sealants to age 16 (permanent molars, 1 per 36
    months)
  • Space maintainers to age 16 (1 per 24 months)
  • Adjunctive pre-diagnostic oral cancer screening (1
    per 12 months for ages 40+)
  • Waiting Period: None
  • Routine exams (2 per 12 months)
  • Prophylaxis (2 per 12 months) (1 additional
    cleaning or periodontal maintenance per 12
    months if member is in 2nd or 3rd trimester of
    pregnancy)
  • Bitewing x-rays (max 4 films:1 per 12 months)
  • Fluoride to age 16 (1 per 12 months)
  • Sealants to age 16 (permanent molars, 1 per 36
    months)
  • Space maintainers to age 16 (1 per 24 months)
  • Adjunctive pre-diagnostic oral cancer screening (1
    per 12 months for ages 40+)
Class B
Basic Services
  • Waiting Period: None
  • Full mouth x-ray (1 per 24 months)
  • Emergency pain (1 per 12 months)
  • Fillings (benefit allowed for amalgam restorations
    on posterior teeth)
  • Simple extractions
  • Waiting Period: None
  • Full mouth x-ray (1 per 24 months)
  • Emergency pain (1 per 12 months)
  • Fillings (benefit allowed for amalgam restorations
    on posterior teeth)
  • Simple extractions
Class C
Major Services
  • Waiting Period: None
  • Anesthesia (subject to review, covered with
    complex oral surgery)
  • Non-surgical periodontics
  • Oral surgery (surgical extractions & impactions)
  • Endodontics (root canals)
  • Surgical periodontics (gum treatments)
  • Inlays
  • Onlays
  • Crowns, bridges, dentures, and endosteal
    implants (in lieu of an approved 3-unit bridge)
  • Repairs: crown, denture, and bridges
  • Waiting Period: None
  • Anesthesia (subject to review, covered with
    complex oral surgery)
  • Non-surgical periodontics
  • Oral surgery (surgical extractions & impactions)
  • Endodontics (root canals)
  • Surgical periodontics (gum treatments)
  • Inlays
  • Onlays
  • Crowns, bridges, dentures, and endosteal
    implants (in lieu of an approved 3-unit bridge)
  • Repairs: crown, denture, and bridges
Class D
Orthodontics
  • Waiting Period: None
  • Orthodontia Lifetime/Annual Maximum:
    $1,000/None
  • Dependent Children to age 19 only
  • Up to 25% of lifetime allowance may be payable
    on initial banding
  • Waiting Period: None
  • Orthodontia Lifetime/Annual Maximum:
    $1,000/None
  • Dependent Children to age 19 only
  • Up to 25% of lifetime allowance may be payable
    on initial banding
THE UNUM DIFFERENCE
DENTAL NETWORKS : Unum Dental members have the freedom to choose a dentist from our large national network. Find a certified, independently reviewed provider and take your dental program to a new level of comprehensive care at unumdentalcare.com .
HEARING SAVINGS PLAN : Offered at no additional cost, the Hearing Savings Plan provides 40% off hearing exams at thousands of locations nationwide, 30-60% discounts off MSRP on name brand hearing instruments, and on-call support from professional hearing counselors.

View the Links Below To Learn More About Our Dental Plans

Click here to enroll in our dental plan.

Click here to fill out our group application for CCA Global Partners Dental & Vision Plans.

Unum Dental Plan Benefit Summary





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