PPO Dental Plan
PREFERRED - PPO
* There is a 12 month waiting period for coverage on these services, unless waived as noted above.
Note: The basis for all benefit payments will be the Healthplex PPO Schedule of Allowances. To determine the actual amount payable for any covered procedure, multiply the appropriate percentage shown above by the Healthplex PPO Fee or by the dentist's fee charged, whichever is less.
Monthly Healthplex Dental PPO Rates