Department of Management Services

2018 Dental Options

The State of Florida offers you comprehensive dental coverage through an array of dental plans. Coverage is available to retirees through COBRA and to COBRA participants if they were enrolled prior to termination.

Each plan is designed to meet the needs of employees based on their individual plan usage, flexibility in using network or non-network dentists and cost.

NEW FOR 2018

Eligible employees and COBRA participants will have new dental plans available for 2018. Two PPO options and one Indemnity with PPO option are available from two different insurers – Ameritas and MetLife. The table below outlines the major differences between the three coverage level options.

If you have any questions about your dental plan, look through the Dental Frequently Asked Questions.

2018 Procured PPO Dental Plan Options
2018 PPO Dental Plan Comparison Chart

2018 PPO Dental Plan Comparison Chart

  Preventive PPO Standard PPO Indemnity with PPO
Can I receive care from any dentist or specialist for covered services? Yes Yes Yes
Can I use my healthcare FSA to cover deductible and out of pocket expenses for me and all covered dependents? Yes Yes Yes
Is there coverage and a waived deductible for preventive services such as exams, x-rays, and cleanings at network providers and 80% for non-network providers? Yes Yes Yes
Is there coverage, with an applicable deductible, for restorative procedures such as fillings, root canals, and extractions at network providers and non-network providers? Yes Yes Yes
Is there coverage for major procedures such as cast restorations (crowns, veneers, etc.), dentures, and bridges? No Yes Yes
Is there coverage for orthodontic services? No Yes Yes
Are there annual maximums per covered insured and if so, what are the plan year limits? Yes - $1,000 per calendar year Yes - $1,500 per calendar year Yes - $2,000 per calendar year
What are the calendar year deductible amounts?

Type I: No deductible

 

Type II services only :

Employee only: $50

Employee + Spouse: $100

Employee + Child(ren): $100

Employee + Spouse +Child(ren): $150

 

Type III: No coverage

Type I: No deductible

 

Type II and Type III services :

Employee only: $50

Employee + Spouse: $100

Employee + Child(ren): $100

Employee + Spouse +Child(ren): $150

Type I: No deductible

 

Type II and Type III services :

Employee only: $50

Employee + Spouse: $100

Employee + Child(ren): $100

Employee + Spouse +Child(ren): $150

What does the plan pay for Type I services?

100% for network providers

80% for non-network providers

100% for network providers

80% for non-network providers

100% for network and non-network providers
What does the plan pay for Type II services?

80% for network providers

50% for non-network providers

80% for network providers

50% for non-network providers

80% for network providers

80% for non-network providers

What does the plan pay for Type III services? No coverage for Type III services

50% for network providers

30% for non-network providers

50% for network providers

50% for non-network providers

What are the lifetime maximums, per insured, for orthodontia treatment? No coverage for orthodontia $2,000 for network providers and $1,500 for non-network providers 50% or $2,500 for both network and non-network providers
Is there a waiting period for orthodontia services? No coverage for orthodontia services There is a one year waiting period for orthodontia services. Creditable coverage will be applied toward waiting period if your dental plan for the 2017 plan year included orthodontia coverage No waiting period
Is there an age limit for orthodontia benefits? No coverage for orthodontia services No age limit No age limit

 

 

Types of Plans and Covered Services

The dental plans below are divided into four categories: PPO, Indemnity, Indemnity with PPO and Prepaid.

These charts show highlights of all the options – focusing on how the plans work. Refer to the plan documents or contact the plans directly for monthly premiums, out-of-pocket costs and specific questions you have about coverage.

Type of Dental Plan  How It Works State Plans Offered
Prepaid Dental Plan
  • Pays benefits only when you use network providers.
  • No deductible or annual maximum
  • Most preventive care at no charge
  • You pay a fixed copayment for dental procedures listed on the copayment schedule.
  • Orthodontia: Covered for adults and children. 
PPO Dental Plan
  • Receive care from any dentist
  • Your cost is lower when you use network dentists
  • You generally have an annual deductible to meet before the plan starts paying benefits, and then you pay part of the cost for the services you receive.
  • Orthodontia: Covered for adults and children (excluding Preventive PPO).
Indemnity with PPO Dental Plan
  • Receive care from any dentist
  • Your cost is lower when you use network dentists
  • You generally have an annual deductible to meet before the plan starts paying benefits, and then you pay a percentage of the cost for the care you receive.
  • Orthodontia: Child only orthodontia covered by Sun Life.
Indemnity 
Dental Plan
  • Receive care from any dentist
  • You have a deductible to meet and then pay part of the cost for the services you receive.