Orange County Managers Association

Many people discover too late that their County-provided dental plan does not cover all costs and procedures. This supplemental Ameritas plan coordinates with your County-provided PPO plan to help cover your out-of-pocket costs that the County-provided plan did not. It also covers procedures that may not be covered by your County plan, for example, implants or child orthodontia.

This plan is a “Scheduled Plan”. It pays a set dollar benefit for each covered procedure and allows you to see any dentist. Therefore, you will know up front exactly how much this insurance will pay! This comprehensive plan covers over 360 dental procedures from the routine preventative, such as cleanings and x-rays, to the major, such as crowns, implants, and dentures.

There is no waiting period for any Preventative, Basic, or Major category services provided the OCAA member is currently covered by a dental plan through Orange County. However, for child orthodontic benefits, the child must be on this plan for 12 months prior to starting treatment and must be under age 17 when starting treatment.

Every family member enrolled will receive a $2,500 benefit per calendar year. For those who use less than $750 of their annual benefit, Ameritas will “bank” up to $400 per year – up to $1,000 in total – for future use. There is a $50 deductible per person, once per calendar year.

Coverage is available for the Association member individually. You may also add coverage for your spouse or domestic partner, and your dependent children up to age 26. Coverage is also available to children age 26 and older if they are permanently disabled and the member lists them as a dependent on their tax return.

The following is a sample list of generic procedure types and the maximum benefit that Ameritas will pay toward that procedure.

^*Multiple American Dental Association (ADA) codes fall under each category. Your specific procedure may use a different ADA code that provides a lower maximum benefit. Consult your dental office before starting any work.

Procedure Type	Maximum Benefit Amount
Prophylaxis (Cleaning)	$54
Periodontal Maintenance	$66
X-Rays	$82
Resin Filling	$121
Root Canal	$495
Extraction of Impacted Tooth	$176
Porcelain Inlay	$331
Porcelain Onlay	$376
Scaling and Root Planing	$107
Porcelain Crown	$393
Denture	$406
Biopsy	$235
Anesthesia	$118
Implant – Surgical Placement	$2,220
Implant – Abutment	$471
Gingivectomy	$149
Excision of Lesion or Cyst	$224
Child Orthodontics	$1,500

Note: The list of procedures has been highly condensed. The maximum coverage column indicates the maximum benefit that Ameritas will pay for each procedure.