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Horizon Dental Plans for Small Groups

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Horizon Dental plans for Small Groups (2 to 50 employees)

Horizon Dental has been providing dental insurance for more than 50 years. We offer affordable, comprehensive coverage for small groups. If you’re considering dental coverage as part of your overall health benefits strategy, see what we have to offer.

Call your Horizon BCBSNJ sales representative or broker for more information.

Horizon Young Grins

Horizon Young Grins, our stand-alone pediatric dental (SAPD) plan, meets the requirements of the Affordable Care Act (ACA). If you purchase medical coverage outside of the Health Insurance Marketplace, you must either attest that you have pediatric dental coverage from another carrier or purchase a SAPD plan.

Small groups can purchase Horizon Young Grins with your medical plan or by itself if you have medical coverage with another company. Horizon BCBSNJ offers pediatric essential benefits as a stand-alone plan to give consumers a choice. Horizon Young Grins offers access to the Horizon PPO Network.

Horizon Young Grins Summary of Benefits

Horizon Family Grins and Horizon Family Grins Plus
Horizon Family Grins provides comprehensive coverage for children and their parents or guardians. Both Horizon Family Grins and Horizon Family Grins Plus offer access to the Horizon PPO Network, an extensive network of dentists. Both plans offer varying levels of benefits depending on the customer’s needs. This plan meets the ACA requirement for pediatric dental benefits.

Horizon Family Grins Summary of Benefits
Horizon Family Grins Plus Summary of Benefits

Horizon Healthy Smiles and Horizon Healthy Smiles Plus

Horizon Healthy Smile plans offer comprehensive coverage at an affordable price. Both plans provide access to the Horizon PPO Network. With Horizon Healthy Smiles Plus, members can also use the Horizon Traditional Network. There are no out-of-network benefits.

Both plans provide a $1,000 benefit to help pay for those services outside of preventive and diagnostic services. In addition, there are varying levels of coinsurance available, along with coverage for orthodontia.

See Benefit Summaries :

Horizon Healthy Smiles 80_50_50 Sm Grp
Horizon Healthy Smiles 100_80_50 Sm Grp
Horizon Healthy Smiles Plus 80_50_50 Sm Grp
Horizon Healthy Smiles Plus 100_80_50 Sm Grp

Horizon Dental Option Plan (DOP)

Horizon Dental Option Plan

Horizon DOP offers your company ways to save money without reducing employee benefits. Your employees have the option of selecting from more than 200,000 participating dental offices nationwide. By choosing dentists who participate with the Horizon Dental Option Plan, your employees maximize their benefits while reducing out-of-pocket costs. Discounts off participating dentists’ charges range between 10 and 30 percent.

Horizon DOP also offers out-of-network benefits, so there’s always a dental benefit and your employees are always covered for eligible services.

Horizon Dental PPO Plan

The Horizon Dental PPO Plan offers some of the lowest out-of-pockets costs available to our customers through our Horizon PPO Network of participating dentists. These dentists accept our negotiated allowances as payment in full, less any applicable deductibles and/or coinsurance.

Members may go to an out-of-network dentist and would receive a discount on covered services, but are responsible for any balance due after the Horizon Dental payment.

See Benefit Summaries :

Horizon Dental PPO D580
Horizon Dental PPO D585
Horizon Dental PPO D587
Horizon Dental PPO D588
Horizon Dental PPO D2643
Horizon Dental PPO D2653
Horizon Dental PPO D2654

Horizon Dental PPO Access Plan

The Horizon Dental PPO Access Plan covers frequently needed, eligible preventive and diagnostic services, and amalgam (silver) fillings at 100 percent when members use a dentist participating in the Horizon PPO Network. There is no annual deductible or annual maximum.

For other services and eligible major or specialty services, such as root canals, crowns and bridges, members pay only a reduced amount to participating dentists. There is no annual deductible, no annual maximum and no waiting period for major services.

The plan allows members to use nonparticipating dentists for certain eligible preventive and diagnostic services, such as exams, cleanings and X-rays, as well as amalgam (silver) fillings and space maintainers. However, they may have to pay for any charges above the allowance, pay dentists at the time of service and submit claims for reimbursement. There is no out-of-network benefit for other eligible basic services and eligible major or specialty services.

Horizon Dental Companion Plan

The Horizon Dental Companion Plan is similar to the Horizon Dental PPO Access Plan, but sold only to groups that have Horizon BCBSNJ medical coverage. The plan covers frequently needed, eligible preventive and diagnostic services and selected eligible basic services at 100 percent when members use dentists participating in the Horizon PPO Network. There is no annual deductible or annual maximum.

The Horizon Dental Companion Plan covers frequently needed, eligible preventive and diagnostic services, such as exams, cleanings and X-rays, as well as amalgam (silver) fillings and space maintainers, at 100 percent. For other eligible remaining basic services and eligible major or specialty services, such as root canals, crowns and bridges, members pay only a reduced, negotiated fee to participating dentists. There is no annual deductible, no annual maximum and no waiting period for major services.

The plan allows members to use nonparticipating dentists for certain eligible preventive and diagnostic services, such as exams, cleanings and X-rays, as well as amalgam (silver) fillings and space maintainers. However, they may have to pay for any charges above the negotiated fee, pay dentists at the time of service and submit claims for reimbursement. There is no out-of-network benefit for other eligible basic services and eligible major or specialty services.