Namara Marketplace
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2016 QHP Landscape OR Individual Market Dental
|
State Code
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County Name
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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 1
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Major Dental Care Adult 1
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Orthodontia Adult 1
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Dental Check-Up For Children
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Basic Dental Care Child 1
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Major Dental Care Child 1
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Orthodontia Child 1
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Premium Rates
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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 On Exchange
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Dental Deductible - Individual - Standard
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Dental Deductible - Family - Standard
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Dental Deductible - Family (Per Person) - Standard
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Dental Maximum Out Of Pocket - Individual - Standard
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Dental Maximum Out Of Pocket - Family - Standard
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Dental Maximum Out Of Pocket - Family (Per Person) - Standard
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Routine Dental Services Adult
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Basic Dental Care Adult
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Major Dental Care Adult
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Orthodontia Adult
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Dental Checkup For Children
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Basic Dental Care Child
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Major Dental Care Child
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Orthodontia Child
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
OR
|
Baker
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.98
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
50.4
|
50.4
|
50.4
|
50.4
|
50.4
|
77.38
|
77.38
|
77.38
|
77.38
|
104.36
|
104.36
|
104.36
|
104.36
|
131.34
|
131.34
|
131.34
|
131.34
|
52.18
|
52.18
|
52.18
|
52.18
|
79.16
|
79.16
|
79.16
|
79.16
|
106.14
|
106.14
|
106.14
|
106.14
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Benton
|
Low
|
Dental Health Services, Inc.
|
25486OR0020001
|
SmartSmile
|
EPO
|
Rating Area 2
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
14.75
|
17.25
|
17.25
|
17.25
|
17.25
|
17.25
|
29.5
|
34.5
|
34.5
|
34.5
|
34.5
|
53.75
|
58.75
|
58.75
|
58.75
|
78
|
83
|
83
|
83
|
102.25
|
107.25
|
107.25
|
107.25
|
39
|
41.5
|
41.5
|
41.5
|
63.25
|
65.75
|
65.75
|
65.75
|
87.5
|
90
|
90
|
90
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$25
|
$52
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Benton
|
Low
|
Dental Health Services, Inc.
|
25486OR0020002
|
Super SmartSmile
|
EPO
|
Rating Area 2
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
23.5
|
26
|
26
|
26
|
26
|
26
|
47
|
52
|
52
|
52
|
52
|
71.25
|
76.25
|
76.25
|
76.25
|
95.5
|
100.5
|
100.5
|
100.5
|
119.75
|
124.75
|
124.75
|
124.75
|
47.75
|
50.25
|
50.25
|
50.25
|
72
|
74.5
|
74.5
|
74.5
|
96.25
|
98.75
|
98.75
|
98.75
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$10
|
$35
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Benton
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 2
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
27.81
|
25.98
|
25.98
|
25.98
|
25.98
|
25.98
|
25.98
|
51.96
|
51.96
|
51.96
|
51.96
|
51.96
|
79.77
|
79.77
|
79.77
|
79.77
|
107.58
|
107.58
|
107.58
|
107.58
|
135.39
|
135.39
|
135.39
|
135.39
|
53.79
|
53.79
|
53.79
|
53.79
|
81.6
|
81.6
|
81.6
|
81.6
|
109.41
|
109.41
|
109.41
|
109.41
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Benton
|
Low
|
Trillium Community Health Plan
|
95417OR0140001
|
Trillium Bright Family Dental - Low
|
PPO
|
Rating Area 2
|
Allows Adult and Child-Only
|
SERFF
|
1-541-431-1950
|
http://www.trilliumchp.com/Marketplace/prov-search.php
|
http://www.trilliumchp.com/Marketplace/PDFS/2016/ExchDen/EXCH_SB23V4-2016-Trillium-Bright-Family-Low-SOB.pdf
|
X
|
X
|
X
|
X
|
X
|
28.61
|
15.06
|
16.57
|
16.82
|
19.12
|
22.84
|
24.84
|
30.12
|
33.64
|
38.24
|
45.68
|
49.68
|
58.73
|
62.25
|
66.85
|
74.29
|
87.34
|
90.86
|
95.46
|
102.9
|
115.95
|
119.47
|
124.07
|
131.51
|
43.67
|
45.43
|
47.73
|
51.45
|
72.28
|
74.04
|
76.34
|
80.06
|
100.89
|
102.65
|
104.95
|
108.67
|
$75
|
$225
|
$75
|
350
|
700
|
$350
|
No Charge
|
30% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
Not Covered
|
|||||||||
|
OR
|
Benton
|
Low
|
Willamette Dental Insurance, Inc.
|
60013OR0020002
|
Willamette Dental ProCare Oregon Plan 1
|
EPO
|
Rating Area 2
|
Allows Adult and Child-Only
|
SERFF
|
1-855-433-6825
|
1-855-433-6825
|
http://www.willamettedental.com/locations-oregon.htm
|
https://www.willamettedental.com/procare-oregon
|
http://willamettedental.gelfuzion.net/_literature_225953/2016_ProCare_Oregon_Plan_1_Benefit_Summary
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
30.4
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
82.64
|
82.64
|
82.64
|
82.64
|
82.64
|
113.04
|
113.04
|
113.04
|
113.04
|
143.44
|
143.44
|
143.44
|
143.44
|
173.84
|
173.84
|
173.84
|
173.84
|
71.72
|
71.72
|
71.72
|
71.72
|
102.12
|
102.12
|
102.12
|
102.12
|
132.52
|
132.52
|
132.52
|
132.52
|
$0
|
$0
|
$0
|
350
|
700
|
Not Applicable
|
$45
|
$45
|
$600
|
$3,000
|
$35
|
$45
|
$600
|
$3,000
|
||||
|
OR
|
Clackamas
|
Low
|
Dental Health Services, Inc.
|
25486OR0020001
|
SmartSmile
|
EPO
|
Rating Area 1
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
14.75
|
17.25
|
17.25
|
17.25
|
17.25
|
17.25
|
29.5
|
34.5
|
34.5
|
34.5
|
34.5
|
53.75
|
58.75
|
58.75
|
58.75
|
78
|
83
|
83
|
83
|
102.25
|
107.25
|
107.25
|
107.25
|
39
|
41.5
|
41.5
|
41.5
|
63.25
|
65.75
|
65.75
|
65.75
|
87.5
|
90
|
90
|
90
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$25
|
$52
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Clackamas
|
Low
|
Dental Health Services, Inc.
|
25486OR0020002
|
Super SmartSmile
|
EPO
|
Rating Area 1
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
23.5
|
26
|
26
|
26
|
26
|
26
|
47
|
52
|
52
|
52
|
52
|
71.25
|
76.25
|
76.25
|
76.25
|
95.5
|
100.5
|
100.5
|
100.5
|
119.75
|
124.75
|
124.75
|
124.75
|
47.75
|
50.25
|
50.25
|
50.25
|
72
|
74.5
|
74.5
|
74.5
|
96.25
|
98.75
|
98.75
|
98.75
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$10
|
$35
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Clackamas
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 1
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
27.96
|
26.12
|
26.12
|
26.12
|
26.12
|
26.12
|
26.12
|
52.24
|
52.24
|
52.24
|
52.24
|
52.24
|
80.2
|
80.2
|
80.2
|
80.2
|
108.16
|
108.16
|
108.16
|
108.16
|
136.12
|
136.12
|
136.12
|
136.12
|
54.08
|
54.08
|
54.08
|
54.08
|
82.04
|
82.04
|
82.04
|
82.04
|
110
|
110
|
110
|
110
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Clackamas
|
Low
|
Trillium Community Health Plan
|
95417OR0140001
|
Trillium Bright Family Dental - Low
|
PPO
|
Rating Area 1
|
Allows Adult and Child-Only
|
SERFF
|
1-541-431-1950
|
http://www.trilliumchp.com/Marketplace/prov-search.php
|
http://www.trilliumchp.com/Marketplace/PDFS/2016/ExchDen/EXCH_SB23V4-2016-Trillium-Bright-Family-Low-SOB.pdf
|
X
|
X
|
X
|
X
|
X
|
30.38
|
15.99
|
17.6
|
17.86
|
20.31
|
24.26
|
26.38
|
31.98
|
35.72
|
40.62
|
48.52
|
52.76
|
62.36
|
66.1
|
71
|
78.9
|
92.74
|
96.48
|
101.38
|
109.28
|
123.12
|
126.86
|
131.76
|
139.66
|
46.37
|
48.24
|
50.69
|
54.64
|
76.75
|
78.62
|
81.07
|
85.02
|
107.13
|
109
|
111.45
|
115.4
|
$75
|
$225
|
$75
|
350
|
700
|
$350
|
No Charge
|
30% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
Not Covered
|
|||||||||
|
OR
|
Clackamas
|
Low
|
Willamette Dental Insurance, Inc.
|
60013OR0020002
|
Willamette Dental ProCare Oregon Plan 1
|
EPO
|
Rating Area 1
|
Allows Adult and Child-Only
|
SERFF
|
1-855-433-6825
|
1-855-433-6825
|
http://www.willamettedental.com/locations-oregon.htm
|
https://www.willamettedental.com/procare-oregon
|
http://willamettedental.gelfuzion.net/_literature_225953/2016_ProCare_Oregon_Plan_1_Benefit_Summary
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
30.4
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
82.64
|
82.64
|
82.64
|
82.64
|
82.64
|
113.04
|
113.04
|
113.04
|
113.04
|
143.44
|
143.44
|
143.44
|
143.44
|
173.84
|
173.84
|
173.84
|
173.84
|
71.72
|
71.72
|
71.72
|
71.72
|
102.12
|
102.12
|
102.12
|
102.12
|
132.52
|
132.52
|
132.52
|
132.52
|
$0
|
$0
|
$0
|
350
|
700
|
Not Applicable
|
$45
|
$45
|
$600
|
$3,000
|
$35
|
$45
|
$600
|
$3,000
|
||||
|
OR
|
Clatsop
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 5
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
27.8
|
25.97
|
25.97
|
25.97
|
25.97
|
25.97
|
25.97
|
51.94
|
51.94
|
51.94
|
51.94
|
51.94
|
79.74
|
79.74
|
79.74
|
79.74
|
107.54
|
107.54
|
107.54
|
107.54
|
135.34
|
135.34
|
135.34
|
135.34
|
53.77
|
53.77
|
53.77
|
53.77
|
81.57
|
81.57
|
81.57
|
81.57
|
109.37
|
109.37
|
109.37
|
109.37
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Clatsop
|
Low
|
Trillium Community Health Plan
|
95417OR0140001
|
Trillium Bright Family Dental - Low
|
PPO
|
Rating Area 5
|
Allows Adult and Child-Only
|
SERFF
|
1-541-431-1950
|
http://www.trilliumchp.com/Marketplace/prov-search.php
|
http://www.trilliumchp.com/Marketplace/PDFS/2016/ExchDen/EXCH_SB23V4-2016-Trillium-Bright-Family-Low-SOB.pdf
|
X
|
X
|
X
|
X
|
X
|
27.95
|
14.71
|
16.19
|
16.43
|
18.68
|
22.31
|
24.27
|
29.42
|
32.86
|
37.36
|
44.62
|
48.54
|
57.37
|
60.81
|
65.31
|
72.57
|
85.32
|
88.76
|
93.26
|
100.52
|
113.27
|
116.71
|
121.21
|
128.47
|
42.66
|
44.38
|
46.63
|
50.26
|
70.61
|
72.33
|
74.58
|
78.21
|
98.56
|
100.28
|
102.53
|
106.16
|
$75
|
$225
|
$75
|
350
|
700
|
$350
|
No Charge
|
30% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
Not Covered
|
|||||||||
|
OR
|
Columbia
|
Low
|
Dental Health Services, Inc.
|
25486OR0020001
|
SmartSmile
|
EPO
|
Rating Area 5
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
14.75
|
17.25
|
17.25
|
17.25
|
17.25
|
17.25
|
29.5
|
34.5
|
34.5
|
34.5
|
34.5
|
53.75
|
58.75
|
58.75
|
58.75
|
78
|
83
|
83
|
83
|
102.25
|
107.25
|
107.25
|
107.25
|
39
|
41.5
|
41.5
|
41.5
|
63.25
|
65.75
|
65.75
|
65.75
|
87.5
|
90
|
90
|
90
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$25
|
$52
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Columbia
|
Low
|
Dental Health Services, Inc.
|
25486OR0020002
|
Super SmartSmile
|
EPO
|
Rating Area 5
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
23.5
|
26
|
26
|
26
|
26
|
26
|
47
|
52
|
52
|
52
|
52
|
71.25
|
76.25
|
76.25
|
76.25
|
95.5
|
100.5
|
100.5
|
100.5
|
119.75
|
124.75
|
124.75
|
124.75
|
47.75
|
50.25
|
50.25
|
50.25
|
72
|
74.5
|
74.5
|
74.5
|
96.25
|
98.75
|
98.75
|
98.75
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$10
|
$35
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Columbia
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 5
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
27.8
|
25.97
|
25.97
|
25.97
|
25.97
|
25.97
|
25.97
|
51.94
|
51.94
|
51.94
|
51.94
|
51.94
|
79.74
|
79.74
|
79.74
|
79.74
|
107.54
|
107.54
|
107.54
|
107.54
|
135.34
|
135.34
|
135.34
|
135.34
|
53.77
|
53.77
|
53.77
|
53.77
|
81.57
|
81.57
|
81.57
|
81.57
|
109.37
|
109.37
|
109.37
|
109.37
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Columbia
|
Low
|
Willamette Dental Insurance, Inc.
|
60013OR0020002
|
Willamette Dental ProCare Oregon Plan 1
|
EPO
|
Rating Area 5
|
Allows Adult and Child-Only
|
SERFF
|
1-855-433-6825
|
1-855-433-6825
|
http://www.willamettedental.com/locations-oregon.htm
|
https://www.willamettedental.com/procare-oregon
|
http://willamettedental.gelfuzion.net/_literature_225953/2016_ProCare_Oregon_Plan_1_Benefit_Summary
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
30.4
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
82.64
|
82.64
|
82.64
|
82.64
|
82.64
|
113.04
|
113.04
|
113.04
|
113.04
|
143.44
|
143.44
|
143.44
|
143.44
|
173.84
|
173.84
|
173.84
|
173.84
|
71.72
|
71.72
|
71.72
|
71.72
|
102.12
|
102.12
|
102.12
|
102.12
|
132.52
|
132.52
|
132.52
|
132.52
|
$0
|
$0
|
$0
|
350
|
700
|
Not Applicable
|
$45
|
$45
|
$600
|
$3,000
|
$35
|
$45
|
$600
|
$3,000
|
||||
|
OR
|
Coos
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 5
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
27.8
|
25.97
|
25.97
|
25.97
|
25.97
|
25.97
|
25.97
|
51.94
|
51.94
|
51.94
|
51.94
|
51.94
|
79.74
|
79.74
|
79.74
|
79.74
|
107.54
|
107.54
|
107.54
|
107.54
|
135.34
|
135.34
|
135.34
|
135.34
|
53.77
|
53.77
|
53.77
|
53.77
|
81.57
|
81.57
|
81.57
|
81.57
|
109.37
|
109.37
|
109.37
|
109.37
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Crook
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.98
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
50.4
|
50.4
|
50.4
|
50.4
|
50.4
|
77.38
|
77.38
|
77.38
|
77.38
|
104.36
|
104.36
|
104.36
|
104.36
|
131.34
|
131.34
|
131.34
|
131.34
|
52.18
|
52.18
|
52.18
|
52.18
|
79.16
|
79.16
|
79.16
|
79.16
|
106.14
|
106.14
|
106.14
|
106.14
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Curry
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 5
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
27.8
|
25.97
|
25.97
|
25.97
|
25.97
|
25.97
|
25.97
|
51.94
|
51.94
|
51.94
|
51.94
|
51.94
|
79.74
|
79.74
|
79.74
|
79.74
|
107.54
|
107.54
|
107.54
|
107.54
|
135.34
|
135.34
|
135.34
|
135.34
|
53.77
|
53.77
|
53.77
|
53.77
|
81.57
|
81.57
|
81.57
|
81.57
|
109.37
|
109.37
|
109.37
|
109.37
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Deschutes
|
Low
|
Dental Health Services, Inc.
|
25486OR0020001
|
SmartSmile
|
EPO
|
Rating Area 4
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
14.75
|
17.25
|
17.25
|
17.25
|
17.25
|
17.25
|
29.5
|
34.5
|
34.5
|
34.5
|
34.5
|
53.75
|
58.75
|
58.75
|
58.75
|
78
|
83
|
83
|
83
|
102.25
|
107.25
|
107.25
|
107.25
|
39
|
41.5
|
41.5
|
41.5
|
63.25
|
65.75
|
65.75
|
65.75
|
87.5
|
90
|
90
|
90
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$25
|
$52
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Deschutes
|
Low
|
Dental Health Services, Inc.
|
25486OR0020002
|
Super SmartSmile
|
EPO
|
Rating Area 4
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
23.5
|
26
|
26
|
26
|
26
|
26
|
47
|
52
|
52
|
52
|
52
|
71.25
|
76.25
|
76.25
|
76.25
|
95.5
|
100.5
|
100.5
|
100.5
|
119.75
|
124.75
|
124.75
|
124.75
|
47.75
|
50.25
|
50.25
|
50.25
|
72
|
74.5
|
74.5
|
74.5
|
96.25
|
98.75
|
98.75
|
98.75
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$10
|
$35
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Deschutes
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 4
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.45
|
24.71
|
24.71
|
24.71
|
24.71
|
24.71
|
24.71
|
49.42
|
49.42
|
49.42
|
49.42
|
49.42
|
75.87
|
75.87
|
75.87
|
75.87
|
102.32
|
102.32
|
102.32
|
102.32
|
128.77
|
128.77
|
128.77
|
128.77
|
51.16
|
51.16
|
51.16
|
51.16
|
77.61
|
77.61
|
77.61
|
77.61
|
104.06
|
104.06
|
104.06
|
104.06
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Deschutes
|
Low
|
Trillium Community Health Plan
|
95417OR0140001
|
Trillium Bright Family Dental - Low
|
PPO
|
Rating Area 4
|
Allows Adult and Child-Only
|
SERFF
|
1-541-431-1950
|
http://www.trilliumchp.com/Marketplace/prov-search.php
|
http://www.trilliumchp.com/Marketplace/PDFS/2016/ExchDen/EXCH_SB23V4-2016-Trillium-Bright-Family-Low-SOB.pdf
|
X
|
X
|
X
|
X
|
X
|
28.5
|
15
|
16.5
|
16.75
|
19.04
|
22.75
|
24.74
|
30
|
33.5
|
38.08
|
45.5
|
49.48
|
58.5
|
62
|
66.58
|
74
|
87
|
90.5
|
95.08
|
102.5
|
115.5
|
119
|
123.58
|
131
|
43.5
|
45.25
|
47.54
|
51.25
|
72
|
73.75
|
76.04
|
79.75
|
100.5
|
102.25
|
104.54
|
108.25
|
$75
|
$225
|
$75
|
350
|
700
|
$350
|
No Charge
|
30% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
Not Covered
|
|||||||||
|
OR
|
Deschutes
|
Low
|
Willamette Dental Insurance, Inc.
|
60013OR0020002
|
Willamette Dental ProCare Oregon Plan 1
|
EPO
|
Rating Area 4
|
Allows Adult and Child-Only
|
SERFF
|
1-855-433-6825
|
1-855-433-6825
|
http://www.willamettedental.com/locations-oregon.htm
|
https://www.willamettedental.com/procare-oregon
|
http://willamettedental.gelfuzion.net/_literature_225953/2016_ProCare_Oregon_Plan_1_Benefit_Summary
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
30.4
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
82.64
|
82.64
|
82.64
|
82.64
|
82.64
|
113.04
|
113.04
|
113.04
|
113.04
|
143.44
|
143.44
|
143.44
|
143.44
|
173.84
|
173.84
|
173.84
|
173.84
|
71.72
|
71.72
|
71.72
|
71.72
|
102.12
|
102.12
|
102.12
|
102.12
|
132.52
|
132.52
|
132.52
|
132.52
|
$0
|
$0
|
$0
|
350
|
700
|
Not Applicable
|
$45
|
$45
|
$600
|
$3,000
|
$35
|
$45
|
$600
|
$3,000
|
||||
|
OR
|
Douglas
|
Low
|
Dental Health Services, Inc.
|
25486OR0020001
|
SmartSmile
|
EPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
14.75
|
17.25
|
17.25
|
17.25
|
17.25
|
17.25
|
29.5
|
34.5
|
34.5
|
34.5
|
34.5
|
53.75
|
58.75
|
58.75
|
58.75
|
78
|
83
|
83
|
83
|
102.25
|
107.25
|
107.25
|
107.25
|
39
|
41.5
|
41.5
|
41.5
|
63.25
|
65.75
|
65.75
|
65.75
|
87.5
|
90
|
90
|
90
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$25
|
$52
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Douglas
|
Low
|
Dental Health Services, Inc.
|
25486OR0020002
|
Super SmartSmile
|
EPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
23.5
|
26
|
26
|
26
|
26
|
26
|
47
|
52
|
52
|
52
|
52
|
71.25
|
76.25
|
76.25
|
76.25
|
95.5
|
100.5
|
100.5
|
100.5
|
119.75
|
124.75
|
124.75
|
124.75
|
47.75
|
50.25
|
50.25
|
50.25
|
72
|
74.5
|
74.5
|
74.5
|
96.25
|
98.75
|
98.75
|
98.75
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$10
|
$35
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Douglas
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.69
|
24.93
|
24.93
|
24.93
|
24.93
|
24.93
|
24.93
|
49.86
|
49.86
|
49.86
|
49.86
|
49.86
|
76.55
|
76.55
|
76.55
|
76.55
|
103.24
|
103.24
|
103.24
|
103.24
|
129.93
|
129.93
|
129.93
|
129.93
|
51.62
|
51.62
|
51.62
|
51.62
|
78.31
|
78.31
|
78.31
|
78.31
|
105
|
105
|
105
|
105
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Douglas
|
Low
|
Trillium Community Health Plan
|
95417OR0140001
|
Trillium Bright Family Dental - Low
|
PPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-541-431-1950
|
http://www.trilliumchp.com/Marketplace/prov-search.php
|
http://www.trilliumchp.com/Marketplace/PDFS/2016/ExchDen/EXCH_SB23V4-2016-Trillium-Bright-Family-Low-SOB.pdf
|
X
|
X
|
X
|
X
|
X
|
28.38
|
14.94
|
16.44
|
16.69
|
18.97
|
22.66
|
24.64
|
29.88
|
33.38
|
37.94
|
45.32
|
49.28
|
58.26
|
61.76
|
66.32
|
73.7
|
86.64
|
90.14
|
94.7
|
102.08
|
115.02
|
118.52
|
123.08
|
130.46
|
43.32
|
45.07
|
47.35
|
51.04
|
71.7
|
73.45
|
75.73
|
79.42
|
100.08
|
101.83
|
104.11
|
107.8
|
$75
|
$225
|
$75
|
350
|
700
|
$350
|
No Charge
|
30% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
Not Covered
|
|||||||||
|
OR
|
Douglas
|
Low
|
Willamette Dental Insurance, Inc.
|
60013OR0020002
|
Willamette Dental ProCare Oregon Plan 1
|
EPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-855-433-6825
|
1-855-433-6825
|
http://www.willamettedental.com/locations-oregon.htm
|
https://www.willamettedental.com/procare-oregon
|
http://willamettedental.gelfuzion.net/_literature_225953/2016_ProCare_Oregon_Plan_1_Benefit_Summary
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
30.4
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
82.64
|
82.64
|
82.64
|
82.64
|
82.64
|
113.04
|
113.04
|
113.04
|
113.04
|
143.44
|
143.44
|
143.44
|
143.44
|
173.84
|
173.84
|
173.84
|
173.84
|
71.72
|
71.72
|
71.72
|
71.72
|
102.12
|
102.12
|
102.12
|
102.12
|
132.52
|
132.52
|
132.52
|
132.52
|
$0
|
$0
|
$0
|
350
|
700
|
Not Applicable
|
$45
|
$45
|
$600
|
$3,000
|
$35
|
$45
|
$600
|
$3,000
|
||||
|
OR
|
Gilliam
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.98
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
50.4
|
50.4
|
50.4
|
50.4
|
50.4
|
77.38
|
77.38
|
77.38
|
77.38
|
104.36
|
104.36
|
104.36
|
104.36
|
131.34
|
131.34
|
131.34
|
131.34
|
52.18
|
52.18
|
52.18
|
52.18
|
79.16
|
79.16
|
79.16
|
79.16
|
106.14
|
106.14
|
106.14
|
106.14
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Grant
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.98
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
50.4
|
50.4
|
50.4
|
50.4
|
50.4
|
77.38
|
77.38
|
77.38
|
77.38
|
104.36
|
104.36
|
104.36
|
104.36
|
131.34
|
131.34
|
131.34
|
131.34
|
52.18
|
52.18
|
52.18
|
52.18
|
79.16
|
79.16
|
79.16
|
79.16
|
106.14
|
106.14
|
106.14
|
106.14
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Harney
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.98
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
50.4
|
50.4
|
50.4
|
50.4
|
50.4
|
77.38
|
77.38
|
77.38
|
77.38
|
104.36
|
104.36
|
104.36
|
104.36
|
131.34
|
131.34
|
131.34
|
131.34
|
52.18
|
52.18
|
52.18
|
52.18
|
79.16
|
79.16
|
79.16
|
79.16
|
106.14
|
106.14
|
106.14
|
106.14
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Hood River
|
Low
|
Dental Health Services, Inc.
|
25486OR0020001
|
SmartSmile
|
EPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
14.75
|
17.25
|
17.25
|
17.25
|
17.25
|
17.25
|
29.5
|
34.5
|
34.5
|
34.5
|
34.5
|
53.75
|
58.75
|
58.75
|
58.75
|
78
|
83
|
83
|
83
|
102.25
|
107.25
|
107.25
|
107.25
|
39
|
41.5
|
41.5
|
41.5
|
63.25
|
65.75
|
65.75
|
65.75
|
87.5
|
90
|
90
|
90
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$25
|
$52
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Hood River
|
Low
|
Dental Health Services, Inc.
|
25486OR0020002
|
Super SmartSmile
|
EPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
23.5
|
26
|
26
|
26
|
26
|
26
|
47
|
52
|
52
|
52
|
52
|
71.25
|
76.25
|
76.25
|
76.25
|
95.5
|
100.5
|
100.5
|
100.5
|
119.75
|
124.75
|
124.75
|
124.75
|
47.75
|
50.25
|
50.25
|
50.25
|
72
|
74.5
|
74.5
|
74.5
|
96.25
|
98.75
|
98.75
|
98.75
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$10
|
$35
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Hood River
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.98
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
50.4
|
50.4
|
50.4
|
50.4
|
50.4
|
77.38
|
77.38
|
77.38
|
77.38
|
104.36
|
104.36
|
104.36
|
104.36
|
131.34
|
131.34
|
131.34
|
131.34
|
52.18
|
52.18
|
52.18
|
52.18
|
79.16
|
79.16
|
79.16
|
79.16
|
106.14
|
106.14
|
106.14
|
106.14
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Hood River
|
Low
|
Trillium Community Health Plan
|
95417OR0140001
|
Trillium Bright Family Dental - Low
|
PPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
1-541-431-1950
|
http://www.trilliumchp.com/Marketplace/prov-search.php
|
http://www.trilliumchp.com/Marketplace/PDFS/2016/ExchDen/EXCH_SB23V4-2016-Trillium-Bright-Family-Low-SOB.pdf
|
X
|
X
|
X
|
X
|
X
|
27.95
|
14.71
|
16.19
|
16.43
|
18.68
|
22.31
|
24.27
|
29.42
|
32.86
|
37.36
|
44.62
|
48.54
|
57.37
|
60.81
|
65.31
|
72.57
|
85.32
|
88.76
|
93.26
|
100.52
|
113.27
|
116.71
|
121.21
|
128.47
|
42.66
|
44.38
|
46.63
|
50.26
|
70.61
|
72.33
|
74.58
|
78.21
|
98.56
|
100.28
|
102.53
|
106.16
|
$75
|
$225
|
$75
|
350
|
700
|
$350
|
No Charge
|
30% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
Not Covered
|
|||||||||
|
OR
|
Jackson
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.69
|
24.93
|
24.93
|
24.93
|
24.93
|
24.93
|
24.93
|
49.86
|
49.86
|
49.86
|
49.86
|
49.86
|
76.55
|
76.55
|
76.55
|
76.55
|
103.24
|
103.24
|
103.24
|
103.24
|
129.93
|
129.93
|
129.93
|
129.93
|
51.62
|
51.62
|
51.62
|
51.62
|
78.31
|
78.31
|
78.31
|
78.31
|
105
|
105
|
105
|
105
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Jackson
|
Low
|
Trillium Community Health Plan
|
95417OR0140001
|
Trillium Bright Family Dental - Low
|
PPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-541-431-1950
|
http://www.trilliumchp.com/Marketplace/prov-search.php
|
http://www.trilliumchp.com/Marketplace/PDFS/2016/ExchDen/EXCH_SB23V4-2016-Trillium-Bright-Family-Low-SOB.pdf
|
X
|
X
|
X
|
X
|
X
|
28.38
|
14.94
|
16.44
|
16.69
|
18.97
|
22.66
|
24.64
|
29.88
|
33.38
|
37.94
|
45.32
|
49.28
|
58.26
|
61.76
|
66.32
|
73.7
|
86.64
|
90.14
|
94.7
|
102.08
|
115.02
|
118.52
|
123.08
|
130.46
|
43.32
|
45.07
|
47.35
|
51.04
|
71.7
|
73.45
|
75.73
|
79.42
|
100.08
|
101.83
|
104.11
|
107.8
|
$75
|
$225
|
$75
|
350
|
700
|
$350
|
No Charge
|
30% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
Not Covered
|
|||||||||
|
OR
|
Jackson
|
Low
|
Willamette Dental Insurance, Inc.
|
60013OR0020002
|
Willamette Dental ProCare Oregon Plan 1
|
EPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-855-433-6825
|
1-855-433-6825
|
http://www.willamettedental.com/locations-oregon.htm
|
https://www.willamettedental.com/procare-oregon
|
http://willamettedental.gelfuzion.net/_literature_225953/2016_ProCare_Oregon_Plan_1_Benefit_Summary
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
30.4
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
82.64
|
82.64
|
82.64
|
82.64
|
82.64
|
113.04
|
113.04
|
113.04
|
113.04
|
143.44
|
143.44
|
143.44
|
143.44
|
173.84
|
173.84
|
173.84
|
173.84
|
71.72
|
71.72
|
71.72
|
71.72
|
102.12
|
102.12
|
102.12
|
102.12
|
132.52
|
132.52
|
132.52
|
132.52
|
$0
|
$0
|
$0
|
350
|
700
|
Not Applicable
|
$45
|
$45
|
$600
|
$3,000
|
$35
|
$45
|
$600
|
$3,000
|
||||
|
OR
|
Jefferson
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.98
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
25.2
|
50.4
|
50.4
|
50.4
|
50.4
|
50.4
|
77.38
|
77.38
|
77.38
|
77.38
|
104.36
|
104.36
|
104.36
|
104.36
|
131.34
|
131.34
|
131.34
|
131.34
|
52.18
|
52.18
|
52.18
|
52.18
|
79.16
|
79.16
|
79.16
|
79.16
|
106.14
|
106.14
|
106.14
|
106.14
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Jefferson
|
Low
|
Willamette Dental Insurance, Inc.
|
60013OR0020002
|
Willamette Dental ProCare Oregon Plan 1
|
EPO
|
Rating Area 6
|
Allows Adult and Child-Only
|
SERFF
|
1-855-433-6825
|
1-855-433-6825
|
http://www.willamettedental.com/locations-oregon.htm
|
https://www.willamettedental.com/procare-oregon
|
http://willamettedental.gelfuzion.net/_literature_225953/2016_ProCare_Oregon_Plan_1_Benefit_Summary
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
30.4
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
82.64
|
82.64
|
82.64
|
82.64
|
82.64
|
113.04
|
113.04
|
113.04
|
113.04
|
143.44
|
143.44
|
143.44
|
143.44
|
173.84
|
173.84
|
173.84
|
173.84
|
71.72
|
71.72
|
71.72
|
71.72
|
102.12
|
102.12
|
102.12
|
102.12
|
132.52
|
132.52
|
132.52
|
132.52
|
$0
|
$0
|
$0
|
350
|
700
|
Not Applicable
|
$45
|
$45
|
$600
|
$3,000
|
$35
|
$45
|
$600
|
$3,000
|
||||
|
OR
|
Josephine
|
Low
|
Dental Health Services, Inc.
|
25486OR0020001
|
SmartSmile
|
EPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
14.75
|
17.25
|
17.25
|
17.25
|
17.25
|
17.25
|
29.5
|
34.5
|
34.5
|
34.5
|
34.5
|
53.75
|
58.75
|
58.75
|
58.75
|
78
|
83
|
83
|
83
|
102.25
|
107.25
|
107.25
|
107.25
|
39
|
41.5
|
41.5
|
41.5
|
63.25
|
65.75
|
65.75
|
65.75
|
87.5
|
90
|
90
|
90
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$25
|
$52
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Josephine
|
Low
|
Dental Health Services, Inc.
|
25486OR0020002
|
Super SmartSmile
|
EPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-855-495-0907
|
1-855-495-0907
|
http://www.dentalhealthservices.com/members/provider-search/index.cfm?state=OR&plan=idp&popup=&fa=search
|
http://www.dentalhealthservices.com/OR/
|
http://www.dentalhealthservices.com/OR/
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
24.25
|
23.5
|
26
|
26
|
26
|
26
|
26
|
47
|
52
|
52
|
52
|
52
|
71.25
|
76.25
|
76.25
|
76.25
|
95.5
|
100.5
|
100.5
|
100.5
|
119.75
|
124.75
|
124.75
|
124.75
|
47.75
|
50.25
|
50.25
|
50.25
|
72
|
74.5
|
74.5
|
74.5
|
96.25
|
98.75
|
98.75
|
98.75
|
Not Applicable
|
Not Applicable
|
Not Applicable
|
350
|
700
|
Not Applicable
|
$10
|
$35
|
$625
|
$3,495
|
$45
|
$50
|
$350
|
$350
|
||||
|
OR
|
Josephine
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.69
|
24.93
|
24.93
|
24.93
|
24.93
|
24.93
|
24.93
|
49.86
|
49.86
|
49.86
|
49.86
|
49.86
|
76.55
|
76.55
|
76.55
|
76.55
|
103.24
|
103.24
|
103.24
|
103.24
|
129.93
|
129.93
|
129.93
|
129.93
|
51.62
|
51.62
|
51.62
|
51.62
|
78.31
|
78.31
|
78.31
|
78.31
|
105
|
105
|
105
|
105
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Josephine
|
Low
|
Trillium Community Health Plan
|
95417OR0140001
|
Trillium Bright Family Dental - Low
|
PPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-541-431-1950
|
http://www.trilliumchp.com/Marketplace/prov-search.php
|
http://www.trilliumchp.com/Marketplace/PDFS/2016/ExchDen/EXCH_SB23V4-2016-Trillium-Bright-Family-Low-SOB.pdf
|
X
|
X
|
X
|
X
|
X
|
28.38
|
14.94
|
16.44
|
16.69
|
18.97
|
22.66
|
24.64
|
29.88
|
33.38
|
37.94
|
45.32
|
49.28
|
58.26
|
61.76
|
66.32
|
73.7
|
86.64
|
90.14
|
94.7
|
102.08
|
115.02
|
118.52
|
123.08
|
130.46
|
43.32
|
45.07
|
47.35
|
51.04
|
71.7
|
73.45
|
75.73
|
79.42
|
100.08
|
101.83
|
104.11
|
107.8
|
$75
|
$225
|
$75
|
350
|
700
|
$350
|
No Charge
|
30% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
Not Covered
|
|||||||||
|
OR
|
Josephine
|
Low
|
Willamette Dental Insurance, Inc.
|
60013OR0020002
|
Willamette Dental ProCare Oregon Plan 1
|
EPO
|
Rating Area 7
|
Allows Adult and Child-Only
|
SERFF
|
1-855-433-6825
|
1-855-433-6825
|
http://www.willamettedental.com/locations-oregon.htm
|
https://www.willamettedental.com/procare-oregon
|
http://willamettedental.gelfuzion.net/_literature_225953/2016_ProCare_Oregon_Plan_1_Benefit_Summary
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
30.4
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
41.32
|
82.64
|
82.64
|
82.64
|
82.64
|
82.64
|
113.04
|
113.04
|
113.04
|
113.04
|
143.44
|
143.44
|
143.44
|
143.44
|
173.84
|
173.84
|
173.84
|
173.84
|
71.72
|
71.72
|
71.72
|
71.72
|
102.12
|
102.12
|
102.12
|
102.12
|
132.52
|
132.52
|
132.52
|
132.52
|
$0
|
$0
|
$0
|
350
|
700
|
Not Applicable
|
$45
|
$45
|
$600
|
$3,000
|
$35
|
$45
|
$600
|
$3,000
|
||||
|
OR
|
Klamath
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 4
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.45
|
24.71
|
24.71
|
24.71
|
24.71
|
24.71
|
24.71
|
49.42
|
49.42
|
49.42
|
49.42
|
49.42
|
75.87
|
75.87
|
75.87
|
75.87
|
102.32
|
102.32
|
102.32
|
102.32
|
128.77
|
128.77
|
128.77
|
128.77
|
51.16
|
51.16
|
51.16
|
51.16
|
77.61
|
77.61
|
77.61
|
77.61
|
104.06
|
104.06
|
104.06
|
104.06
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
|||||||||
|
OR
|
Klamath
|
Low
|
Trillium Community Health Plan
|
95417OR0140001
|
Trillium Bright Family Dental - Low
|
PPO
|
Rating Area 4
|
Allows Adult and Child-Only
|
SERFF
|
1-541-431-1950
|
http://www.trilliumchp.com/Marketplace/prov-search.php
|
http://www.trilliumchp.com/Marketplace/PDFS/2016/ExchDen/EXCH_SB23V4-2016-Trillium-Bright-Family-Low-SOB.pdf
|
X
|
X
|
X
|
X
|
X
|
28.5
|
15
|
16.5
|
16.75
|
19.04
|
22.75
|
24.74
|
30
|
33.5
|
38.08
|
45.5
|
49.48
|
58.5
|
62
|
66.58
|
74
|
87
|
90.5
|
95.08
|
102.5
|
115.5
|
119
|
123.58
|
131
|
43.5
|
45.25
|
47.54
|
51.25
|
72
|
73.75
|
76.04
|
79.75
|
100.5
|
102.25
|
104.54
|
108.25
|
$75
|
$225
|
$75
|
350
|
700
|
$350
|
No Charge
|
30% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
Not Covered
|
|||||||||
|
OR
|
Lake
|
Low
|
Dentegra Insurance Company
|
68420OR0010006
|
Dentegra Dental PPO Family Basic Plan
|
PPO
|
Rating Area 4
|
Allows Adult and Child-Only
|
SERFF
|
http://www.dentegra.com/find-a-dentist
|
https://dentegra.com/hcx/or/68420or0010006-16
|
X
|
X
|
X
|
X
|
X
|
X
|
26.45
|
24.71
|
24.71
|
24.71
|
24.71
|
24.71
|
24.71
|
49.42
|
49.42
|
49.42
|
49.42
|
49.42
|
75.87
|
75.87
|
75.87
|
75.87
|
102.32
|
102.32
|
102.32
|
102.32
|
128.77
|
128.77
|
128.77
|
128.77
|
51.16
|
51.16
|
51.16
|
51.16
|
77.61
|
77.61
|
77.61
|
77.61
|
104.06
|
104.06
|
104.06
|
104.06
|
$65
|
See Plan Brochure
|
Not Applicable
|
350
|
700
|
$350
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
Not Covered
|
Not Covered
|
No Charge after Deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
|
50% Coinsurance after deductible
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