BlueDental Premium

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You want to offer your employees a step up from basic coverage.

Covered Preventive Services

Covered Basic Services

Covered Major Services

Orthodontia Services

Plan is available with or without orthodontia coverage
Provides access to one of the nation's most extensive dental networks
Preventive services are a focus
Coverage offered through a partnership with United Concordia Dental (UCD)
Employers must contribute a minimum of 75% of the cost of each employee's individual premium payment

	Premium	Premium+
Employer Contribution: To qualify for group dental plan, the employer must contribute a minimum of 75% toward the individual contract premium payment. Employer Participation: Coverage for dental programs are only available to groups of three employees or more. For further details on the coverage, including exclusions, any reductions or limitations and the terms under which the benefit plan may be continued, see your account executive. United Concordia Companies, Inc. is an independent company providing dental benefit administration services and access to provider network for the Blue Cross Blue Shield of North Dakota dental products.
Available for Group Size	10+	10+
Deductible	Member: $50 Family: $100	Member: $50 Family: $100
Annual Maximum (per member)	$1,000	$1,000
Orthodontic Lifetime Maximum	N/A	$1,500
Prophylaxis (cleanings)	80%	80%
Preventive Exam	80%	80%
Preventive Diagnostic	80%	80%
Fluoride	80%	80%
Palliative Emergency Care	80%	80%
Sealants	80%	80%
Fillings	80%	80%
Simple Extractions	80%	80%
Anesthesia	80%	80%
Space Maintainers	80%	80%
Surgical Extractions	80%	80%
Endodontics	80%	80%
Periodontics	80%	80%
Crowns & Inlays	50%	50%
Prosthodontics (removable)	50%	50%
Prosthodontics (fixed)	50%	50%
Surgical Implants	50%	50%
Complex Oral Surgery	50%	50%
Oral Maxillofacial Surgery	50%	50%
Occlusal Guard	50%	50%

Your account executive can help find the right plan for your organization.

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Fargo (Headquarters)
4510 13th Ave. S.
Fargo, North Dakota 58121