Medium Business Plans (10-99 Employees)
CapDent
The CapDent Plan is different from conventional dental programs with deductibles, maximums and other features that increase your out-of-pocket expenses. CapDent provides covered services through a network of participating dentists with no claim forms, lengthy predeterminations or waiting periods to cover pre-existing conditions. [Learn more]
CapDent Plus
Because affordability and choice are what members want in dental benefits, we put both into this enhanced dental plan. Sure to please purchasers as well as patients, the heart of this true point-of-service dental program is an affordable managed care plan using a network of participating dentists. Diagnostic and preventive services are covered in full, with minimal cost to patients for additional services. There are no deductibles, no maximums and no waiting periods for any treatment in-network. [Learn more]
CapDent Select
The CapDent Select Plan is different from conventional dental programs with deductibles, maximums and other features that increase your out-of-pocket expenses. CapDent Select provides covered services through a network of participating dentists with no claim forms, lengthy predeterminations or waiting periods to cover pre-existing conditions. For CapDent Select plans, members receive an increased benefit when seeing a participating PPO specialist, with a referral. [Learn more]
CapDent Plus Select
Because affordability and choice are what members want in dental benefits, we put both into this enhanced dental plan. Sure to please purchasers as well as patients, the heart of this true point-of-service dental program is an affordable managed care plan using a network of participating dentists. Diagnostic and preventive services are covered in full, with minimal cost to patients for additional services. There are no deductibles, no maximums and no waiting periods for any treatment in-network. For CapDent Plus Select plans, members receive an increased benefit when seeing a participating PPO specialist, with a referral. [Learn more]
Custom DHMO Plans
Based on the principle that it is less expensive to prevent dental disease than it is to treat dental disease. Managed Care Dental Plans or Dental HMOs offer comprehensive coverage at greatly reduced costs. Patients receive needed treatment and groups receive stable premiums - everyone benefits. Managed Care Plans include more coverage at lower costs. Many services are covered in full, including diagnostic and preventive treatment. Other services are covered with patient copayments that are a fraction of the usual and customary dental fees.[Learn more]
Preferred Choice
If you are a small business owner looking to provide quality dental coverage to your employees, then the Preferred Choice Dental Plan is for you. This PPO dental plan is designed with small businesses in mind, providing comprehensive dental benefits with very reasonable premiums. [Learn more]
OMNI
As the largest independent dental benefit company in the Northeast, Healthplex specializes in the design and administration of quality dental plans with comprehensive coverage and reasonable premiums. The OMNI Dental Plan is one of our most flexible programs and uses our largest network of participating dentists. If you are a small or large business owner looking to provide quality dental coverage to your employees, then the OMNI Dental Plan is for you. [Learn more]
Custom PPO Plans
This fee-for-service program provides two important features needed by all organizations - solid administrative support and proven cost control. Our experience is unsurpassed when it comes to designing and implementing custom benefit packages. We can help you select from, and control, a broad range of features including deductibles, maximums, waiting periods, reimbursement levels, eligibility requirements, exclusions and limitations. We provide you with timely information and will deliver superior service to your members. [Learn more]
Plan Comparison - Healthplex Medium Business Plans
| Healthplex Medium Business Plans | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| CapDent NY CapDent NJ |
CapDent Plus1 | CapDent Select | CapDent Plus Select1 | Custom DHMO Plan |
Preferred Choice | OMNI PPO |
Custom PPO Plans |
||
| Rates | |||||||||
| Single | NY | $13.25 | $22.00 | $18.00 | $29.00 | Rates vary based on custom plan chosen | $15.42 | $33.50 | Rates vary based on custom plan chosen |
| NJ | $12.80 | N/A | N/A | N/A | N/A | ||||
| Two Party | NY | $22.00 | $38.00 | $31.00 | $52.00 | $30.38 | $65.00 | ||
| NJ | $25.65 | N/A | N/A | N/A | N/A | ||||
| Family | NY | $30.00 | $55.00 | $45.00 | $72.00 | $52.28 | $87.00 | ||
| NJ | $36.65 | N/A | N/A | N/A | N/A | ||||
| Type of Plan | In-Net Only | In/Out-of-Net | In-Net Only | In/Out-of-Net | In-Net Only | In-Net and Out-of-Network | |||
| Office Visit Fee | $0.00 | $5.00 | $0.00 | $5.00 | $0.00 | $0.00 | $0.00 | $0.00 | |
| Maximums | None5 | $1200 per person per year | $1250 per person per year | Maximums range from $1000 to $3000 | |||||
| Deductibles (waived for Diagnostic & Preventive) | None5 | $40 Per person | $50 Individual $150 Family |
No deductible plans and $50/$150 deductibles offered | |||||
| Waiting Periods2 | None5 | 12 Mos. Prosthetics 24 Mos. Ortho. |
12 Mos. Prosthetics | 12 Mos. Prosthetics | |||||
| Claim Forms | None5 | Yes | Yes | Yes | |||||
| Services | Reimbursements | ||||||||
| Type I: Diagnostic & Preventive | No Copays | No Copays | No Copays | No Copays | No Copays | Based on Zip code |
100% | Plan Offerings Plan I: 100/100/100 Plan II: 100/80/50 Plan III: 80/80/80 Plan IV: 100/80/0 Plan V: 50/50/50 Plan X: 100/100/50 Plan XI: 100/0/0 Plan options include: Ortho - 50%, with a $1000 max or No Ortho - $3350 Copays |
|
| Type II: Basic | Copays Apply 3 | Copays Apply | Copays Apply 4 | Copays Apply 4 | Plans range from no Copays to plans with low Copays for these services. | 80% | |||
| Type III: Major | Copays Apply 3 | Copays Apply | Copays Apply 4 | Copays Apply 4 | 50% | ||||
| Type IV: Orthodontia | When services are rendered by a Capdent specialist, members receive a 25% discount off usual and customary fees. | $3350 Copay | $3350 Copay | $3350 Copay | |||||
| Panel | CapDent Panel | CapDent Panel | General Dentist: CapDent Specialist: Healthplex PPO |
Dentcare Panel IHS Panel |
Healthplex PPO | Healthplex PPO | Healthplex PPO Liberty PPO Metro PPO |
Vision Benefit | Yes | Yes | Yes | Yes | No | Yes | Yes | No |