Plan Information

Renaissance MAX Choice PLUS Plan

This is a PPO plan. Plan participants have access to over 200,000 nationally credentialed dental PPO provider access points.

Individuals may visit any dentist, but will receive the best benefits by seeing a dentist who participates in the Renaissance PPO network. MAX Choice Plus gives you more value if you visit an out-of-network dentist by paying claims at a higher level of reimbursement than our MAX Choice (PPO MAC) plan option.

No waiting periods on any services.

Max Choice PLUS Plan Fee Schedule

*When visiting a PPO dentist. Out-of-network fees are paid at 80th percentile.

Billing and eligibility administration provided by Morgan-White Administrators, Inc.

Covered Services Plan Pays
Year 1 Year 2 Year 3
Diagnostic & Preventive Services Used to evaluate existing conditions and/or to prevent dental abnormalities or disease (includes exams, cleanings, bitewing x-rays and fluoride treatments) 100% 100% 100%
Basic Procedures:
  • Emergency palliative treatment - Used to temporarily relieve pain
  • Bitewing Radiographs- bitewing X-rays
  • Fluoride Treatment- topical application of fluoride
  • Periodontal Maintenance - Periodontal maintenance following active periodontal therapy
40% 60% 80%
  • Minor Restorative Services - Used to repair teeth damaged by disease or injury (for example, silver fillings and white fillings )
20% 40% 50%
Major Procedures:
  • Oral Surgery Services - Extractions and dental surgery, including local anesthesia, suturing, if needed, and routine post-operative care, services for the diagnosis and treatment of temporomandibular disorders
  • Endodontic Services - Used to treat teeth with diseased or damaged nerves (for example, root canals)
  • Periodontic Services - Used to treat diseases of the gums and supporting structures of the teeth
  • Major Restorative Services - Used when teeth can't be restored with another filling material (for example, crowns)
  • Prosthodontic Services - Used to replace missing natural teeth (for example, bridges and dentures, and certain implant services)
  • Relines and Repairs - Relines and repairs to bridges, removable bridges, partial dentures, and complete dentures
  • Occlusal Guards - Benefits for occlusal guards, and limited occlusal adjustments
20% 40% 50%
Orthodontia Procedures:
($1,200 lifetime maximum per person for this benefit)
Orthodontic benefits are only available for eligible dependent children up to age 19. 10% 25% 50%

Annual Deductible per person/family for Basic and Major Services Only.

The Deductible does not apply for Diagnostic and Preventive or Orthodontic Services.

$50/$150 $50/$150 $50/$150
Annual Maximum $1,000 $2,000 $3,000