Spirit Ameritas Calculator | Direct Benefits Inc.

Agent/Agency Information

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Group Information

Employer Name:

State:

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Dental Plan Design

Plan Base:

Employee Enrollment:

Participation:

12 Months Comparable Prior Group Dental Coverage:

Choose a Deductible:

Annual Maximum:

Additional Options

100% Family-related enrolled, applies to dental & vision (+15%)

$1,500 Lifetime Child & Adult Orthodontia (+flat amount)

Endodontics/Periodontics to Basic Services (+12%)

Optional Teeth Bleaching (+3%)

Dental Rewards Program (+2%)

Increase from 80th to 90th Percentile (+4%)

The $100 vision max is combined with the dental max. Employees can visit the provider of their choice. Employees will pay the vision provider at time of appointment and request an itemized receipt which they will then use to submit a claim for reimbursement up to the $100 vision maximum.

Vision Plan Design

Choose a Network:

Spirit Ameritas Calculator for MT, RI, PA (restricted)

Additional Options

Spirit Ameritas Calculator
for MT, RI, PA (restricted)