Dental benefits
Plan summary
4021 Ameritas Indemnity
w/PPO
4022 Ameritas
Standard PPO
4023 Ameritas
Preventive PPO
In-network Out-of-network In-network Out-of-network In-network Out-of-network
Annual maximum per person $2,000 $2,000 $1,500 $1,500 $1,000 $1,000
Type 1 Preventive
Cleanings, exams, x-rays,
fluoride (for children), etc.
100% 100% 100% 80% 100% 80%
Type 2 Basic
Fillings, root canals, periodontal work
(treatment of gum disease), extraction
of teeth, etc.
80% 80% 80% 50% 80% 50%
Type 3 Major
Crowns, dentures, bridges,
dental implant, etc.
50% 50% 50% 30% 0% 0%
Allowance
Discounted
Fee
Average
U & C
Discounted
Fee
Average
U & C
Discounted
Fee
Average
U & C
Waiting period None None None None None None
Deductible: Type 2 and/or Type 3
Employee Employee and spouse Employee and children Employee and family
Amount per
calendar year
$50 $100 $100 $150
Orthodontia benefits
Orthodontia summary
4021 Ameritas Indemnity
w/PPO
4022 Ameritas
Standard PPO
4023 Ameritas
Preventive PPO
Allowance (all plans) In-network: Discounted fee; Out-of-network: U & C
Plan benefit 50%
50% In-network
30% Out-of-network
N/A
Deductible None $50/Lifetime
Coverage for adults Yes Yes
Lifetime maximum
(per person)
$2,500
$2,000 In-network
$1,500 Out-of-network
Waiting period None
12 months
Can be satisfied with
prior credible coverage
Monthly rates
Monthly rates 4021 Ameritas Indemnity
w/PPO
4022 Ameritas
Standard PPO
4023 Ameritas
Preventive PPO
Employee only $47.24 $31.64 $21.64
Employee and spouse $87.64 $59.24 $40.92
Employee and children $99.80 $66.32 $43.80
Employee, spouse and children
$144.08 $96.56 $64.16
Compare your three dental plan options for 2025
For more information, visit explore.ameritas.com/stateoffl
or call 800-776-9446.
2025 Group Dental Plan
For State of Florida employees and families
GR 7605 FL 8-24
We’re proud to protect your smile. Dental insurance is just as important to a lifetime of good
health as your medical plan. But caring for your teeth, and making sure your loved ones have
good oral health care, can be expensive. You can offset these expenses by taking advantage of
Ameritas dental benefits exclusively for State of Florida employees and theirfamilies.
Things to know:
• The Ameritas Classic & Plus Dental Network is a
large PPO network that continues to grow year after
year. So you have convenient access to both general
and specialty dental providers without the need for
areferral.
• You are free to visit any provider you choose! Your
out-of-pocket costs may be 25-50% lower when
visiting a network provider.
• When visiting an out-of-network provider, if the
dentist’s charge is more than your plan allowance,
this will be an out-of pocket expense foryou.
• Network providers accept payment directly from
Ameritas, an option which is also available to out-of-
network providers.
• You can nominate a dentist to join the network via the
link on the State of Florida dental benets site. Use the
QR code or call our provider relations team at
800-755-8844.
• Find a Dental Provider on your
dental benets site, and view
your Ameritas Classic & Plus
Dental Network listing of general
and specialty providers.
How to enroll
Enroll electronically on the People First website at https://peoplefirst.myflorida.com
This is not a certificate of insurance or guarantee of coverage. Plan designs may not be available in all areas and are subject to individual state regulations. This piece is not for use in New Mexico. This
information is provided by Ameritas Life Insurance Corp. (Ameritas Life). Dental, vision and hearing care products (9000 Rev. 07-23 for Group and 9000 Rev. 10-22 for Individual, dates may vary by state) are
issued by Ameritas Life. The Dental and Vision Networks are not available in RI. In Texas, our dental network and plans are referred to as the Ameritas Dental Network. For WV residents, view the access plan
as required by the Health Benefit Plan Network Access and Adequacy Act. Ameritas, the bison design and “fulfilling life” are service marks or registered service marks of Ameritas Life, affiliate Ameritas Holding
Company or Ameritas Mutual Holding Company. © 2024 Ameritas Mutual Holding Company.
800-776-9446 ameritas.com
View more plan details and a dental plan video on your dental
benefits site at explore.ameritas.com/stateoffl.
Claims, benefit and provider
network questions:
[email protected] | 877-721-2224
Monday - Thursday, 7 a.m. – Midnight (CST)
Friday, 7 a.m. – 6:30 p.m. (CST)
877-721-2224
¿en español? Ameritas offers Spanish-
speaking claims center representatives and
a variety of Spanish documents, as well as
telephone interpretation services in a wide range
oflanguages.
For plan limitations and exclusions, scan this QR code,
select the Dental page and scroll down.
https://explore.ameritas.com/stateoffl