Flex Plan
Our FLEX Plan allows members to choose what they value most; better coverage or more provider choice.
How it works:
- Voluntary or employer paid down to five eligible lives
- Upon enrollment, members select the plan option that best meets their needs
- Members can switch between plan options at the end of each benefit year
- Identical premium rates for either plan option
| FLEX Plus | FLEX Basic | |
| Plan Coverage | Superior plan coverage 100/100/60 | Traditional plan coverage of 100/80/50 |
| Network | Over 300,00 nationwide PPO providers* Out-of-network payments based on PPO network rates | Visit any dentist nationwide Out-of-network payments based on UCR |
| Savings | Lowest out-of-pocket costs when seeing a participating network dentist | Flexibility to see any dentist with great coverage in- or out-of-network |
Two plan options, one affordable rate.
At Renaissance, we challenge the status quo by delivering flexible plans that employers and employees want. With options for flexible pricing and a variety of plan types, we offer benefits you won’t find anywhere else.
| Dental Benefit Highlights | FLEX Plus | FLEX Basic |
| Plan Pays | Plan Pays | |
Diagnostic and Preventative Services | ||
| Diagnostic and Preventive Services includes exams, cleanings, fluoride and space maintainers | 100% | 100% |
| Brush Biopsy to detect oral cancer | 100% | 100% |
| Radiographs X-rays | 100% | 100% |
| Sealants to prevent decay of permanent molars | 100% | 100% |
Basic Services | ||
| Emergency Palliative Treatment to temporarily relieve pain | 100% | 80% |
| Periodontic Services to treat gum disease | 100% | 80% |
| Endodontic Services root canals | 100% | 80% |
| Oral Surgery Services extractions and dental surgery | 100% | 80% |
| Minor Restorative Services fillings | 100% | 80% |
| Other Basic Services miscellaneous services | 100% | 80% |
Major Services (12 month waiting period) | ||
| Re-lines and Repairs to bridges, implants and dentures | 60% | 50% |
| Major Restorative Services crowns | 60% | 50% |
| Prosthodontic services bridges, implants and dentures | 60% | 50% |
Orthodontics (Up to age 19) | ||
| Orthodontic services braces | 50% | 50% |
Maximums | ||
| Policy year maximum payment applies to diagnostic and preventive, basic and major services | $1,500/person | $1,500/person |
| Lifetime maximum orthodontics | $1,500/person | $1,500/person |
Annual Deductible | ||
| Policy year deductible (enrollee/family maximum) applies to all services except diagnostic and preventive and orthodontics | $50/$150 | $50/$150 |
Allowed Amounts | ||
| Allowed amount in-network providers | PPO Fee | PPO Fee |
| Allowed amount out-of-network providers | PPO Fee | 90th percentile |
NOTES: Theses summaries are samples of benefits. Policies have exclusions and limitations that may limit coverage. For complete coverage details, please refer to your Certificate of Coverage.
EXCLUSIONS: Cosmetic surgery or dentistry for aesthetic reasons (except reconstructive surgery for children because of congenital disease or anomaly); general anesthesia and/or intravenous sedation; treatment by anyone other than a licensed dentist or dental hygienist; veneers; services related to temporomandibular disorders (“TMD”); prefabricated crowns as final restoration on permanent teeth and paste-type root canal fillings on permanent teeth; appliances, procedures and restorations for increasing vertical dimension, occlusion, tooth structure loss due to attrition, abrasion or erosion, or for periodontal splinting; lost, missing or stolen appliances; services not in the Certificate of Coverage and/or Summary of Dental Plan Benefits.
LIMITATIONS: Coverage for services may be limited based on the age of the person receiving the services; coverage for certain services may be limited to a maximum number of occurrences during a specified time period (such as two times per year or one time every three years).
The premium rate will vary between plans. The Certificate of Coverage has a term of one year and will automatically renew (upon payment of required premium) unless terminated in accordance with its provisions. Coverage may be terminated for reasons stated in the Certificate of Coverage. Coverage ceases upon termination. Products and services referred to herein may not be available in all states or jurisdictions.
Note: The above schedule of benefits is meant to be a summary of coverage. Please see the insured certificate for a legal interpretation of benefits.
*Renaissance internal data 2017