Namara Marketplace

QHP Landscape SHOP Market Dental

State

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County

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Metal Level

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Issuer Name

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Plan Id (Standard Component)

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Plan Marketing Name

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Plan Type

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Rating Area

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Child Only Offering

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Source

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Customer Service Phone Number Local

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Customer Service Phone Number Toll Free

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Customer Service Phone Number Tty

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Network Url

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Plan Brochure Url

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Summary Of Benefits Url

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Drug Formulary Url

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Routine Dental Services Adult 1

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Basic Dental Care - Adult

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Major Dental Care - Adult

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Orthodontia Adult 1

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Dental Check-Up For Children

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Basic Dental Care - Child

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Major Dental Care - Child

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Orthodontia Child 1

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Premium Scenarios

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Premium Child

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Premium Adult Individual Age 21

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Premium Adult Individual Age 27

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Premium Adult Individual Age 30

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Premium Adult Individual Age 40

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Premium Adult Individual Age 50

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Premium Adult Individual Age 60

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Premium Couple 21

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Premium Couple 30

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Premium Couple 40

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Premium Couple 50

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Premium Couple 60

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Couple+1 Child, Age 21

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Couple+1 Child, Age 30

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Couple+1 Child, Age 40

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Couple+1 Child, Age 50

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Couple+2 Children, Age 21

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Couple+2 Children, Age 30

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Couple+2 Children, Age 40

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Couple+2 Children, Age 50

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Couple+3 Or More Children, Age 21

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Couple+3 Or More Children, Age 30

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Couple+3 Or More Children, Age 40

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Couple+3 Or More Children, Age 50

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Individual+1 Child, Age 21

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Individual+1 Child, Age 30

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Individual+1 Child, Age 40

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Individual+1 Child, Age 50

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Individual+2 Children, Age 21

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Individual+2 Children, Age 30

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Individual+2 Children, Age 40

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Individual+2 Children, Age 50

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Individual+3 Or More Children, Age 21

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Individual+3 Or More Children, Age 30

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Individual+3 Or More Children, Age 40

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Individual+3 Or More Children, Age 50

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Standard Plan Cost Sharing

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Dental Deductible - Individual

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Dental Deductible -Family

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Maximum Out Of Pocket - Individual

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Maximum Out Of Pocket -Family

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Routine Dental Services Adult

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Basic Dental Adult

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Major Dental Adult

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Orthodontia Adult

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Dental Check-Up Child

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Basic Dental Child

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Major Dental Child

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Orthodontia Child

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AK
ALEUTIANS EAST
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
60.67
60.67
60.67
60.67
60.67
60.67
60.67
121.34
121.34
121.34
121.34
121.34
170.05
170.05
170.05
170.05
218.76
218.76
218.76
218.76
286.95
286.95
286.95
286.95
109.38
109.38
109.38
109.38
158.09
158.09
158.09
158.09
226.28
226.28
226.28
226.28
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
ALEUTIANS EAST
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
46.42
46.42
46.42
46.42
46.42
46.42
46.42
92.83
92.83
92.83
92.83
92.83
138.87
138.87
138.87
138.87
184.91
184.91
184.91
184.91
249.37
249.37
249.37
249.37
92.46
92.46
92.46
92.46
138.5
138.5
138.5
138.5
202.95
202.95
202.95
202.95
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
ALEUTIANS EAST
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
ALEUTIANS EAST
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
ALEUTIANS EAST
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
ALEUTIANS WEST
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
60.67
60.67
60.67
60.67
60.67
60.67
60.67
121.34
121.34
121.34
121.34
121.34
170.05
170.05
170.05
170.05
218.76
218.76
218.76
218.76
286.95
286.95
286.95
286.95
109.38
109.38
109.38
109.38
158.09
158.09
158.09
158.09
226.28
226.28
226.28
226.28
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
ALEUTIANS WEST
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
46.42
46.42
46.42
46.42
46.42
46.42
46.42
92.83
92.83
92.83
92.83
92.83
138.87
138.87
138.87
138.87
184.91
184.91
184.91
184.91
249.37
249.37
249.37
249.37
92.46
92.46
92.46
92.46
138.5
138.5
138.5
138.5
202.95
202.95
202.95
202.95
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
ALEUTIANS WEST
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
ALEUTIANS WEST
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
ALEUTIANS WEST
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
ANCHORAGE
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 1
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
60.49
60.49
60.49
60.49
60.49
60.49
60.49
120.98
120.98
120.98
120.98
120.98
169.55
169.55
169.55
169.55
218.11
218.11
218.11
218.11
286.1
286.1
286.1
286.1
109.06
109.06
109.06
109.06
157.62
157.62
157.62
157.62
225.61
225.61
225.61
225.61
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
ANCHORAGE
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 1
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
46.28
46.28
46.28
46.28
46.28
46.28
46.28
92.56
92.56
92.56
92.56
92.56
138.46
138.46
138.46
138.46
184.37
184.37
184.37
184.37
248.63
248.63
248.63
248.63
92.18
92.18
92.18
92.18
138.09
138.09
138.09
138.09
202.36
202.36
202.36
202.36
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
ANCHORAGE
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 1
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
ANCHORAGE
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 1
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
ANCHORAGE
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 1
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
BETHEL
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 1
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
60.49
60.49
60.49
60.49
60.49
60.49
60.49
120.98
120.98
120.98
120.98
120.98
169.55
169.55
169.55
169.55
218.11
218.11
218.11
218.11
286.1
286.1
286.1
286.1
109.06
109.06
109.06
109.06
157.62
157.62
157.62
157.62
225.61
225.61
225.61
225.61
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
BETHEL
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 1
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
46.28
46.28
46.28
46.28
46.28
46.28
46.28
92.56
92.56
92.56
92.56
92.56
138.46
138.46
138.46
138.46
184.37
184.37
184.37
184.37
248.63
248.63
248.63
248.63
92.18
92.18
92.18
92.18
138.09
138.09
138.09
138.09
202.36
202.36
202.36
202.36
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
BETHEL
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 1
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
BETHEL
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 1
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
BETHEL
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 1
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
BRISTOL BAY BOROUGH
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
60.67
60.67
60.67
60.67
60.67
60.67
60.67
121.34
121.34
121.34
121.34
121.34
170.05
170.05
170.05
170.05
218.76
218.76
218.76
218.76
286.95
286.95
286.95
286.95
109.38
109.38
109.38
109.38
158.09
158.09
158.09
158.09
226.28
226.28
226.28
226.28
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
BRISTOL BAY BOROUGH
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
46.42
46.42
46.42
46.42
46.42
46.42
46.42
92.83
92.83
92.83
92.83
92.83
138.87
138.87
138.87
138.87
184.91
184.91
184.91
184.91
249.37
249.37
249.37
249.37
92.46
92.46
92.46
92.46
138.5
138.5
138.5
138.5
202.95
202.95
202.95
202.95
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
BRISTOL BAY BOROUGH
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
BRISTOL BAY BOROUGH
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
BRISTOL BAY BOROUGH
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
DENALI
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
60.67
60.67
60.67
60.67
60.67
60.67
60.67
121.34
121.34
121.34
121.34
121.34
170.05
170.05
170.05
170.05
218.76
218.76
218.76
218.76
286.95
286.95
286.95
286.95
109.38
109.38
109.38
109.38
158.09
158.09
158.09
158.09
226.28
226.28
226.28
226.28
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
DENALI
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
46.42
46.42
46.42
46.42
46.42
46.42
46.42
92.83
92.83
92.83
92.83
92.83
138.87
138.87
138.87
138.87
184.91
184.91
184.91
184.91
249.37
249.37
249.37
249.37
92.46
92.46
92.46
92.46
138.5
138.5
138.5
138.5
202.95
202.95
202.95
202.95
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
DENALI
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
DENALI
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
DENALI
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
DILLINGHAM
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 1
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
60.49
60.49
60.49
60.49
60.49
60.49
60.49
120.98
120.98
120.98
120.98
120.98
169.55
169.55
169.55
169.55
218.11
218.11
218.11
218.11
286.1
286.1
286.1
286.1
109.06
109.06
109.06
109.06
157.62
157.62
157.62
157.62
225.61
225.61
225.61
225.61
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
DILLINGHAM
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 1
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
46.28
46.28
46.28
46.28
46.28
46.28
46.28
92.56
92.56
92.56
92.56
92.56
138.46
138.46
138.46
138.46
184.37
184.37
184.37
184.37
248.63
248.63
248.63
248.63
92.18
92.18
92.18
92.18
138.09
138.09
138.09
138.09
202.36
202.36
202.36
202.36
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
DILLINGHAM
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 1
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
DILLINGHAM
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 1
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
DILLINGHAM
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 1
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
FAIRBANKS NORTH STAR
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
60.67
60.67
60.67
60.67
60.67
60.67
60.67
121.34
121.34
121.34
121.34
121.34
170.05
170.05
170.05
170.05
218.76
218.76
218.76
218.76
286.95
286.95
286.95
286.95
109.38
109.38
109.38
109.38
158.09
158.09
158.09
158.09
226.28
226.28
226.28
226.28
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
FAIRBANKS NORTH STAR
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
46.42
46.42
46.42
46.42
46.42
46.42
46.42
92.83
92.83
92.83
92.83
92.83
138.87
138.87
138.87
138.87
184.91
184.91
184.91
184.91
249.37
249.37
249.37
249.37
92.46
92.46
92.46
92.46
138.5
138.5
138.5
138.5
202.95
202.95
202.95
202.95
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
FAIRBANKS NORTH STAR
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
FAIRBANKS NORTH STAR
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
FAIRBANKS NORTH STAR
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 2
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
HAINES
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 3
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
51.1
51.1
51.1
51.1
51.1
51.1
51.1
102.19
102.19
102.19
102.19
102.19
143.22
143.22
143.22
143.22
184.24
184.24
184.24
184.24
241.67
241.67
241.67
241.67
92.12
92.12
92.12
92.12
133.13
133.13
133.13
133.13
190.58
190.58
190.58
190.58
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
HAINES
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 3
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
39.09
39.09
39.09
39.09
39.09
39.09
39.09
78.18
78.18
78.18
78.18
78.18
116.96
116.96
116.96
116.96
155.74
155.74
155.74
155.74
210.02
210.02
210.02
210.02
77.87
77.87
77.87
77.87
116.64
116.64
116.64
116.64
170.93
170.93
170.93
170.93
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
HAINES
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 3
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
HAINES
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 3
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
HAINES
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 3
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
Hoonah-Angoon
Low
BEST Life
74819AK0010005
BEST Dental Plus - Silver
PPO
Rating Area 3
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Plus_Plan_(Silver).pdf
X
X
X
X
X
X
X
51.1
51.1
51.1
51.1
51.1
51.1
51.1
102.19
102.19
102.19
102.19
102.19
143.22
143.22
143.22
143.22
184.24
184.24
184.24
184.24
241.67
241.67
241.67
241.67
92.12
92.12
92.12
92.12
133.13
133.13
133.13
133.13
190.58
190.58
190.58
190.58
50
See Plan Brochure
700
1400
No Charge
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
Hoonah-Angoon
Low
BEST Life
74819AK0010006
BEST Dental Basic - Silver
PPO
Rating Area 3
Allows Adult and Child-Only
HIOS
1-949-253-4080
1-800-433-0088
1-949-222-2134
http://www2.dentemax.com/
http://www.bestlife.com/AK/pdf/AK_BEST_Dental_Basic_Plan_(Silver).pdf
X
X
X
X
X
X
X
39.09
39.09
39.09
39.09
39.09
39.09
39.09
78.18
78.18
78.18
78.18
78.18
116.96
116.96
116.96
116.96
155.74
155.74
155.74
155.74
210.02
210.02
210.02
210.02
77.87
77.87
77.87
77.87
116.64
116.64
116.64
116.64
170.93
170.93
170.93
170.93
50
See Plan Brochure
700
1400
No Charge
50% Coinsurance after deductible
70% Coinsurance after deductible
Not Covered
No Charge after Deductible
45% Coinsurance after deductible
65% Coinsurance after deductible
50%
AK
Hoonah-Angoon
Low
Delta Dental of Alaska
21989AK0020002
Premier
PPO
Rating Area 3
Allows Adult and Child-Only
HIOS
1-888-873-1395
1-888-873-1395
1-888-873-1395
https://www.modahealth.com/ProviderSearch/faces/webpages/home.xhtml?dn=ods
https://www.modahealth.com/producers/grp/den.shtml
https://www.modahealth.com/producers/grp/den.shtml
X
X
X
X
X
X
X
32.45
32.45
32.45
32.45
32.45
32.45
32.45
64.9
64.9
64.9
64.9
64.9
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
126.95
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
94.5
50
$100
700
1400
20%
40%
50%
Not Covered
20%
40%
50%
50%
AK
Hoonah-Angoon
Low
Guardian Life Insurance Company of America
42507AK0050001
Guardian Family Essentials Plus
Indemnity
Rating Area 3
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
117.37
117.37
117.37
117.37
158.38
158.38
158.38
158.38
219.93
219.93
219.93
219.93
79.16
79.16
79.16
79.16
120.18
120.18
120.18
120.18
181.72
181.72
181.72
181.72
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%
AK
Hoonah-Angoon
Low
Guardian Life Insurance Company of America
42507AK0060001
Guardian Family Essentials
Indemnity
Rating Area 3
Allows Adult and Child-Only
HIOS
1-888-600-1600
1-888-600-1600
https://www.guardiananytime.com/fpapp/FPWeb/dentalSearch.process
http://www.guardianlife.com/small-business-exchanges/
X
X
X
X
X
X
X
38.13
38.13
38.13
38.13
38.13
38.13
38.13
76.34
76.34
76.34
76.34
76.34
113.45
113.45
113.45
113.45
150.56
150.56
150.56
150.56
206.22
206.22
206.22
206.22
75.23
75.23
75.23
75.23
112.35
112.35
112.35
112.35
168.01
168.01
168.01
168.01
50
See Plan Brochure
700
1400
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
Not Covered
20%
30% Coinsurance after deductible
60% Coinsurance after deductible
50%

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