Preferred Provider Organizations (PPO)
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 OMNI Dental Plan is for you. [Learn more]
Preferred Choice
If you are a small business owner looking to provide quality dental coverage to your employees, then 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]
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 PPO Plans
| Healthplex PPO Plans | |||
|---|---|---|---|
| Preferred Choice | OMNI PPO | Custom PPO Plans | |
| Rates | |||
| Single | $15.42 | $33.50 | Rates Vary based on the Custom Plan Chosen |
| Two Party | $30.38 | $65.00 | Rates Vary based on the Custom Plan Chosen |
| Family | $52.28 | $87.00 | Rates Vary based on the Custom Plan Chosen |
| Type of Plan | In-Network and Out-Of-Network | ||
| Office Visit Fee | $0.00 | $0.00 | $0.00 |
| Maximums | $1200 per person per year | $1250 per person per year | Maximums range from $1000 to $3000 | Deductibles (waived for Diagnostic & Preventive) | $40 Per Person | $50 Individual $150 Family |
No deductible and $50/$150 deductible plans offered |
| Waiting Periods 1 (waived for prior coverage) |
12 Mos. Prosthetics 24 Mos. Orthodontics |
12 Mos. Prosthetics | 12 Mos. Prosthetics |
| Services | |||
| Type I: Diagnostic & Preventive | Set Reimbursements | 100% Reimbursements | 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 - Copayments based upon location |
| Type II: Basic | Set Reimbursements | 80% Reimbursements | |
| Type III: Major | Set Reimbursements | 50% Reimbursements | |
| Type IV: Orthodontia | Set Reimbursements | $3350 Copayment | Panel | Healthplex PPO Panel | Healthplex PPO Panel | Healthplex PPO Panel Healthplex Liberty Panel Healthplex Metro Panel |
Vision Benefit | Yes | Yes | No |