Dental Benefits

State Dental Plan

The State Dental Plan is provided at no cost to the employee ONLY if the employee is enrolled in the dental plan.  For an additional premium cost, you may add your eligible dependents. Dental plan benefits are divided into four categories called classes.

Key features of the dental plan are:

  • Class I - Diagnostic and preventive services are provided up to 100% of the allowable charge.
  • Class II - Basic dental services such as fillings and simple extractions - up to 80% of the fee schedule.
  • Class III - Prosthetic services include crowns, onlays and bridges are provided up to 50% of the allowable charge.
  • Class IV - Orthodontic - 50% of the allowable charge to a lifetime maximum of $1,000 and is available to covered children age 18 and younger.

Classes I, II and III:  There is a combined $1,000 annual maximum per insured.

Classes II and III:     $25 combined deductible for each benefit period, limited to $75.

Important Notice:  State Dental Plan benefits are paid based on the allowed amounts for each dental procedure listed in the plan's Schedule of Dental Procedures and Allowed Amounts, found at the StateSC.SouthCarolinaBlues.com under Coverage Information, then Dental and Dental Fee Schedule.  Be aware that your dentist's charge may be greater than the allowed amount.

Dental Plus

To participate in Dental Plus, you must also be enrolled in the State Dental Plan and elect the same level of coverage.  The employee is solely responsible for the Dental and Dental Plus premiums.  

  • Class I - Diagnostic and preventive services are provided up to 100% of the allowable charge.
  • Class II - Basic dental services such as fillings and simple extractions up to 80% after State Dental Plan is met.
  • Class III - Prosthetic services include crowns, onlays and bridges are provided up to 50% after the State Dental Plan deductible is met.
  • Class IV - Dental Plus does not offer orthodontia benefits.

The maximum yearly benefit for a person covered by both the State Dental Plan and Dental Plus is $2,000. 

The Dental Plus plan, reimbursement is based on what the dentist charges up to the annual maximum.  Dental Plus allowance is based on amounts that most of the dentists in South Carolina charge for particular services.  This means that your dental expenses will likely fall within these allowances and you will only be responsible for paying the deductible and coinsurance.  If the dentist charges more for covered services than Dental Plus allows, you will be responsible for paying the difference.  The in-network and out-of-network allowed amounts may vary by dentist and/or location.

State Dental and Dental Plus Plan
Blue Cross Blue Shield of South Carolina
P. O. Box 100300, Columbia, SC, 29202-3300
Customer Service:  888-214-6230 or 803-264-7323
FAX:  803-264-7739
website:  statesc.southcarolinablues.com

(premiums are subject to change)

State Dental Monthly Rates for 2018


State Dental Plan

Dental Plus

Total

Employee Only

$ 0.00

$27.12

$ 27.12

Employee/Spouse

$ 7.64

$54.80

$ 62.44

Employee/Child

$13.72

$63.20

$ 76.92

Full Family

$21.34

$82.10

$103.44


Online Resources

On the StateSC.SouthCarolinaBlues.com  website and under the My Health Toolkit member login, you can:
  • Sign up for paperless Explanations of Benefits (EOBs);
  • Locate Dental Plus network providers through the Find a Dentist section;
  • Visit the Dental Resource Center;
  • Review your eligibility and benefits;
  • Check claims and view EOBs;
  • Check pretreatment estimates; and
  • Report other dental coverage.
Members may enroll in or drop the State Dental Plan and Dental Plus:
  • during an initial enrollment in the PBEA's Insurance programs as a new hire.
  • during an open enrollment in the odd-numbered years (the next two opportunities will be October 2019 and October 2021).
  • within 30 days of a special eligibility situation or change in status.

Please refer to the PEBA Insurance Benefits Guide located online at www.peba.sc.gov for additional information.