Delta Dental PPO Plus Premier ™ - Pathfinder MN, ND & NE 2020 Calculator
Please complete the form below to create a quote.
**2021 Rates and Plan Designs Coming Soon**
Agent/Agency Information
Name:
Email:
Phone Number:
Group Information
Employer Name:
State:
Minnesota
North Dakota
Nebraska
Zip Code:
Effective Date:
Dental Plan Design
Select a Plan:
Please choose...
Pathfinder Value
Pathfinder
Employee Enrollment:
Please choose...
2-4 enrolled
5-9 enrolled
10-199 enrolled (max 199 employees eligible)
Choose a Deductible:
Please choose...
$50/$150 Calendar Year
$25/$75 Calendar Year
$0 Calendar Year
$100 Lifetime
Annual Maximum:
Please choose...
$1,000 Annual Maximum
$1,250 Annual Maximum (+5%)
$1,500 Annual Maximum (+9%)
$2,000 Annual Maximum (+19%)
$2,500 Annual Maximum (+23%)
$3,000 Annual Maximum (+26%)
Additional Options
2 year rate guarantee (+3%)
Increase coverage for composite resin (white) fillings to 80% (+5%)
Increase Endodontic/Periodontal coinsurance to 80% (+6%)
Remove waiting period (+11%)
Add child orthodontics (+flat)
Add adult orthodontics (+flat)
Child Ortho Maximum:
Please choose...
$1,000
$1,500
$2,000
Adult Ortho Maximum:
Please choose...
$1,000
Vision Plan Design
Choose a Network:
Please choose...
Spirit EyeMed
Spirit VSP
Spirit EyeMed Plan Options
Plan Base:
Please choose...
Plan A - 12/12/12 $0/$0
Plan B - 12/24/24 $0/$0
Plan C - 12/12/12 $10/$10
Plan D - 12/24/24 $10/$10
Plan E - 12/12/12 $10/$20
Plan F - 12/24/24 $10/$20
Plan G - Materials Only 12/24
Plan H - Materials Only 12/12
Participation:
Please choose...
75% or More
Voluntary, less than 75% (+5%)
Spirit VSP Plan Options
Plan Base:
Please choose...
Plan 1 - 12/12/24 $10/$25
Plan 2 - 12/12/24 $10/$10
Plan 3 - 12/12/12 $10/$25
Plan 4 - 12/12/12 $10/$10
Tier:
Please choose...
Tier 3 -- Employee, Employee + 1, Employee + Family
Tier 4 -- Employee, Employee + Spouse, Employee + Child(ren), Employee + Family
Additional Options
100% family related employer groups (+15%)
Submit