Dental Plan Benefit Summaries

PW_B145882
Anthem Dental Complete Plans
Anthem Dental Complete Voluntary Plans
Anthem Dental Prime Plans
Anthem Dental Prime Voluntary Plans
Anthem Blue Dental PPO Plans
Anthem Blue Dental PPO Plus Plans
Anthem Blue Dental PPO Voluntary Plans
Anthem Blue Dental PPO Plus Voluntary Plans
 
Anthem Dental Complete Plans  
Anthem Dental Complete Plan Option 1
Anthem Dental Complete Plan Option 2
Anthem Dental Complete Plan Option 3
Anthem Dental Complete Plan Option 4
Anthem Dental Complete Plan Option 5
Anthem Dental Complete Plan Option 6
Anthem Dental Complete Plan Option 7
Anthem Dental Complete Plan Option 8
Anthem Dental Complete Plan Option 9
Anthem Dental Complete Plan Option 10
Anthem Dental Complete Plan Option 11
Anthem Dental Complete Plan Option 12
Anthem Dental Complete Plan Option 13
Anthem Dental Complete Plan Option 14
Anthem Dental Complete Plan Option 15
Anthem Dental Complete Plan Option 16
Anthem Dental Complete Plan Option 17
Anthem Dental Complete Plan Option 18
Anthem Dental Complete Plan Option 19
Anthem Dental Complete Plan Option 20
 
Anthem Dental Complete Voluntary Plans 
Dental Complete Voluntary Plan Option 21
Dental Complete Voluntary Plan Option 22
Dental Complete Voluntary Plan Option 23
Dental Complete Voluntary Plan Option 24
Dental Complete Voluntary Plan Option 25
 
Anthem Dental Prime Plans 
Dental Prime Plan Option 1
Dental Prime Plan Option 2
Dental Prime Plan Option 3
Dental Prime Plan Option 4
Dental Prime Plan Option 5
Dental Prime Plan Option 6
Dental Prime Plan Option 7
Dental Prime Plan Option 8
Dental Prime Plan Option 9
Dental Prime Plan Option 10
Dental Prime Plan Option 11
Dental Prime Plan Option 12
Dental Prime Plan Option 13
Dental Prime Plan Option 14
Dental Prime Plan Option 15
Dental Prime Plan Option 16
Dental Prime Plan Option 17
Dental Prime Plan Option 18
Dental Prime Plan Option 19
Dental Prime Plan Option 20
 
Anthem Dental Prime Voluntary Plans 
Dental Prime Voluntary Plan Option 21
Dental Prime Voluntary Plan Option 22
Dental Prime Voluntary Plan Option 23
Dental Prime Voluntary Plan Option 24
Dental Prime Voluntary Plan Option 25
 
Anthem Blue Dental PPO Plans  
Anthem Blue Dental PPO Option 1
Anthem Blue Dental PPO Option 1 with Orthodontics
Anthem Blue Dental PPO Option 2
Anthem Blue Dental PPO Option 3
Anthem Blue Dental PPO Option 3 with Orthodontics
Anthem Blue Dental PPO Option 4  
Anthem Blue Dental PPO Option A1
Anthem Blue Dental PPO Option A2  
Anthem Blue Dental PPO Option A3  
Anthem Blue Dental PPO Option A4  
Anthem Blue Dental PPO Option A5  
Anthem Blue Dental PPO Option A6  
Anthem Blue Dental PPO Option A7  
 
Anthem Blue Dental PPO Plus Plans  
Anthem Blue Dental PPO Plus Option 1  
Anthem Blue Dental PPO Plus Option 1 with Orthodontics  
Anthem Blue Dental PPO Plus Option 2  
Anthem Blue Dental PPO Plus Option 3  
Anthem Blue Dental PPO Plus Option 3 with Orthodontics  
Anthem Blue Dental PPO Plus Option 4  
Anthem Blue Dental PPO Plus Option A1  
Anthem Blue Dental PPO Plus Option A2  
Anthem Blue Dental PPO Plus Option A3  
Anthem Blue Dental PPO Plus Option A4  
Anthem Blue Dental PPO Plus Option A5  
Anthem Blue Dental PPO Plus Option A6  
Anthem Blue Dental PPO Plus Option A7  
 
Anthem Blue Dental PPO Voluntary Plans  
Anthem Blue Dental PPO Voluntary Option 1V  
Anthem Blue Dental PPO Voluntary Option 2V  
Anthem Blue Dental PPO Voluntary Option A8  
Anthem Blue Dental PPO Voluntary Option A9  
Anthem Blue Dental PPO Voluntary Option A9 Ortho Rider  
 
Anthem Blue Dental PPO Plus Voluntary Plans  
Anthem Blue Dental PPO Plus Voluntary Option 1V  
Anthem Blue Dental PPO Plus Voluntary Option 2V  
Anthem Blue Dental PPO Plus Voluntary Option A8  
Anthem Blue Dental PPO Plus Voluntary Option A9  
Anthem Blue Dental PPO Plus Voluntary Option A9 Ortho Rider  
 

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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use