EBPA Dental Plan Options

WDH offers 2 dental plan options; the Core Plan and the Caps/Crowns Plan through EBPA. There is no network of providers, you may see any dentist you choose.

Both plans cover the following dental services at 100%*:(*Paid up to the “Reasonable and Customary” charges for services)

• Cleaning and exam twice per calendar year• X-rays, bitewings twice per calendar year• X-rays, full mouth/panorex once per calendar year• X-rays of individual teeth as necessary• Flouride treatment once in a 12-month period for children through age 18• Space maintainers• Sealants for children through age14 on certain teeth

Deductibles and Plan Year Maximums

Core PlanNo deductiblePlan Year Maximum = $1,000 per person beginning in January

Caps/Crowns Plan$25 per person deductible ($75 per family) per Plan Year Plan Year Maximum = $2,000 per person beginning in January

EBPA Dental Plan Options

The following services are covered by the Core Plan at 50% and by the Caps/Crowns Plan at 80%*:(*Paid up to the reasonable and customary charges for services)

• Fillings• Surgical and routine tooth extractions• Root canal therapy• Treatment of gum disease• Periodontal prophlaxis (cleaning), once per 6-month period• Removeable denture repair to its original condition• Emergency treatment

EBPA Dental Plan Options

The following services are covered under the Caps/Crowns Plan at 50%* (they are not covered by the Core Plan)(*Paid up to the reasonable and customary charges for services)

• Bridges• Partial and complete dentures• Rebase and reline• Crowns• Onlay• Dental implants

More Questions?

EBPA Customer Service hours: Monday through Friday, 8:00 AM – 7:00 PM

1 (800) 578-3272

www.ebpabenefits.com