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Regence Health & Life Insurance Company
Dollar-Based Dental | Incentive-Based Dental
| Individual Dental Insurance |
| Premium Rates |
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Monthly Premium
Per Member |
Quarterly Premium
Per Member |
Dental Only |
Dental & Vision |
Dental Only |
Dental & Vision |
| Under Age 18 |
$25.40 |
$28.01 |
$76.20 |
$84.03 |
| 18 through 64 |
$46.05 |
$50.67 |
$138.15 |
$152.01 |
| 65 and over |
$58.31 |
$64.22 |
$174.93 |
$192.66 |
You may enroll for Dental Only Coverage or Dental with Vision Coverage.
All members must be enrolled for the same coverage and preimum payment schedule |
Individual Dollar-Based Dental Benefits
|
$1,500 Annual Max |
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$1,250 Annual Max |
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$1,000 Annual Max |
$750 Annual Max |
Year 1 |
Year 2 |
Year 3 |
Year 4 |
Plan pays:
100% of the first $150 of care
80% of the next $500 of care
50% of the remaining care until annual benefit maximum is reached |
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| Dollar Based Benefits |
Percent covered |
Benefit payment |
| Year 1 |
$0-$150* |
100% |
$150 |
$151-$650 |
80% |
$400 |
$651-$1050 |
50% |
$200 |
Maximum Policy Year Benefit |
$750 |
| Year 2 |
$0-$150 |
100% |
$150 |
$151-$650 |
80% |
$400 |
$650-$1550 |
50% |
$450 |
Maximum Policy Year Benefit |
$1,000 |
| Year 3 |
$0-$150* |
100% |
$150 |
$151-$650 |
80% |
$400 |
$651-$2050 |
50% |
$700 |
Maximum Policy Year Benefit |
$1,250 |
| Year 4+ |
$0-$150* |
100% |
$150 |
$151-$650 |
80% |
$400 |
$651-$2550 |
50% |
$950 |
Maximum Policy Year Benefit |
$1,500 |
Incentive: You control your benefit increase by receiving at least one cleaning and exam during the benefit year.
- No deductibles
- No limitations or exclusions for covered services, except orthodontia, theeth bleaching and veneers
- Six month waiting period
- Optional Vision Rider available: $150 in services and/or hardware every 24 months
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Assurant Health
