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Dental Plans
The Office Solutions Benefit Program offers you the choice of either the Dental HMO Plan or the Dental PPO Plan, both providing a broad range of coverage for dental procedures.
DHMO Plan
DHMO Plan |
Please click on the DHMO Plan for a complete listing of services and relative copays associated with this plan. Exams, cleanings (also known as 'prophylaxis'), x-rays and most fillings are covered at no-charge.
We recommend that you make a copy of the above referenced list to take with you to your dental appointments so you may always have a reference to what your copay will be for the procedures that are performed. Please note that the frequency of exams, cleanings and x-rays are relative to the plan. |
PPO Plan
PPO Plan |
This plan offers you the option of seeking services from an in-network or out-of-network dentist. It is important to understand that the Dental PPO Plan is not as comprehensive as the DMO plan in that there are limits to the dollar amount of services provided on an annual basis.
Co-insurance levels can change between in and out-of-network services and it’s important that you are aware of the differences before you seek service from an out-of-network dentist. Seeking service in-network will allow you to pay less for the services provided. |
2021 Payroll Deduction Authorization
Payroll Deduction Authorization Form |
In order to view the per-pay-period deduction amounts for the dental plans, please click on the Payroll Deduction Authorization form on the left. If you choose to enroll in any of the plans, please print, complete and sign the form and submit to Human Resources.
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Questions?
For questions about claims, please click on Important Plan/Contract Information under the appropriate line of coverage for the customer service contact number.
For questions regarding plan eligibility, benefits or enrollment forms, contact Thomas Lambert at Ashbrook Clevidence.
Phone: (714) 979-4023
Fax: (714) 979-2809
Email: TomL@aclevidence.com
We thank you for the opportunity to be of service to you and your family!
For questions regarding plan eligibility, benefits or enrollment forms, contact Thomas Lambert at Ashbrook Clevidence.
Phone: (714) 979-4023
Fax: (714) 979-2809
Email: TomL@aclevidence.com
We thank you for the opportunity to be of service to you and your family!
