MWG Traditional Dental Plans

Traditional Plans are available voluntary or employer paid.

Benchmark Plan Open Choice Plan Incentive Plan Opportunity Plan
Plan Type Indemnity Passive PPO Incentive PPO Passive PPO
Reimbursement Method In/Out UCR DPO/UCR DPO UCR DPO/DPO
Diagnostic & Preventive 100% 100% 100% 80% 100%
Minor Restorative 80% 80% 80% 60% 80%
Oral Surgery 80% 80% 80% 60% 80%
Endodontics 50% 50% 50% 40% 50%
Periodontics 50% 50% 50% 40% 50%
Major Services 50% 50% 50% 40% 50%
Ortho (Child Only) 50% 50% 50% 40% 50%
Deductible $50/150 $50/150 $50/150 $50/150
Ded waived for D&P Yes Yes Yes Yes Yes
Annual Maximum $1,000 $1,000 $1,000 $1,000 $1,000
Ortho Lifetime Maximum $1,000 $1,000 $1,000 $1,000 $1,000
Waiting Periods: New Groups: Vary by group size and plan design selected
Takeover Groups: No waiting periods for enrollees and their dependents who were enrolled in employer’s prior plan.

DPO reimbursement is based on the negotiated provider fee schedule; UCR reimbursement is based on Usual, Customary, & Reasonable (UCR) charge.

Benefits

  • Optional 2 year rate guarantee.
  • All plans available, voluntary or employer paid, for new or takeover groups.
  • New groups of 2 to 200 eligible. Takeover groups of 6 to 200 eligible. Minimum 10 enrolled for orthodontia.
  • Flexible plan designs (annual max, orthodontia max, and deductibles.
  • Flexibility to move endodontics and periodontics from 50% to 80%.
  • Dual option plans available.
  • No excluded groups (some industry loads).
  • Extensive national network with over 70,000 providers.
  • Free choice of dentists.
  • No participation percentage for voluntary plans.
  • Standard benefits, limitations, and exclusions apply.

MWG Immediate Coverage Plan

Plan Type: Passive PPO

Reimbursement Method In/Out: DPO / UCR

  1st Benefit Year 2nd Benefit Year Thereafter
Diagnostic & Preventive 100% 100% 100%
Minor Restorative 80% 80% 80%
Oral Surgery 80% 80% 80%
Endodontics 10% 25% 50%
Periodontics 10% 25% 50%
Major Services 10% 25% 50%
Ortho (Child Only) 10% 25% 50%
Deductible $50/150 $50/150 $50/150
Ded waived for D&P Yes Yes Yes
Annual Maximum $1,000 $1,000 $1,000
Ortho Lifetime Maximum $1,000 $1,000 $1,000

DPO reimbursement is based on the negotiated provider fee schedule; UCR reimbursement is based on Usual, Customary, & Reasonable (UCR) charge.

Benefits

  • No waiting periods
  • Optional 2 year rate guarantee.
  • Voluntary or employer paid for new groups
  • New groups of 2 to 200 eligible.
  • Flexible plan designs (annual max, orthodontia max, and deductibles.
  • No excluded groups (some industry loads).
  • Extensive national network with over 70,000 providers.
  • Free choice of dentists.
  • No participation percentage for voluntary plans.
  • Standard benefits, limitations, and exclusions apply.

MWG Package Dental Plans

A two-layer approach to Dental

  A B C
Reimbursement Method In/Out DPO / UCR DPO / UCR DPO / UCR
Diagnostic & Preventive 100% 100% 100%
Minor Restorative Discount Card 80% 80%
Oral Surgery Discount Card 80% 80%
Endodontics Discount Card Discount Card 80%
Periodontics Discount Card Discount Card 80%
Major Serivces Discount Card Discount Card Discount Card
Orthodontics Discount Card Discount Card Discount Card
Deductible $50/150 $50/150 $50/150
Ded waived for D&P Yes Yes Yes
Annual Maximum $1,000 $1,000 $1,000

DPO reimbursement is based on the negotiated provider fee schedule; UCR reimbursement is based on Usual, Customary, & Reasonable (UCR) charge.

Benefits

  • NO WAITING PERIODS
  • All plans available Voluntary or Employer Paid for New or Takeover Groups
  • Plans A & B with 2-200 eligible and Plan C 6-200 eligible with a minimum of 6 enrolled
  • No Excluded Groups (some industry loads)
  • Insured Standard Benefits, Limitations, and Exclusions Apply
  • Monthly Billing Fee- $5.00 with 2 to 5 enrolled and $10.00 with 6+ enrolled

Discount Card

This Plan couples MWG Dental Insurance with a Discount Card to provide dental coverage for all services.

This discount card is not insurance. The card provides discounts from network providers for all services not included under the insurance policy. (Including root canals, crowns, bridges, child and adult ortho, cosmetic treatments, bonding and veneers). No waiting and discounts ranging from 20% to 50%.

Consumer MaxMultiplier Optional Benefit

Consumer MaxMultiplier is a consumer-driven feature included with all of MWG Dental plan designs that puts dental care decisions directly in the hands of the consumer. You have the ability to increase your annual maximum each year at no additional cost.

If no claims are submitted during the benefit period, no awards are earned and there is no penalty or loss of any previously accumulated award balance. Should your group enroll in an MWG Dental plan or if you are a new hire in the last three months of the benefit year your participation in the Consumer MaxMultiplier will be deferred until the first month of the next full benefit period.

See Example. Different original annual maximums have different accumulations.

Consumer MaxMultiplier Design – Specific Plan Options
Original Annual Max Annual Claim Threshold Annual Account Award Annual Network Bonus Annual Award + Bonus Max Increased Annual Maximum
$1,000 $500 $250 $100 $350 2nd year – $1350
$1,000 $500 $250 $100 $350 3rd year – $1700

If you keep your claims below $500 per year, you will carry over $250 dollars toward your next year’s annual maximum. Earn an additional $100 carryover by making all your dental visits to one of our PPO providers. Maximum reward accumulation is $1,000. Awards have no cash value.

Important Policy Provisions

Coverage is subject to certain conditions, limitations and exclusions, which are detailed in the group policy as well as the certificate. If there is a conflict between what is described in this brochure and your group policy, the group policy will prevail. For a complete listing of the plan provisions, as well as any limitations and exclusions, please refer to the group policy

Any provision of the group policy which, on its effective date, does not agree with the laws of the state in which the policy is written, will be amended to the minimum requirements of those laws.

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