CODAC 2025 Benefit Plan Summaries

PPO Bonus When members qualify for Dental Rewards by seeing an Ameritas PPO [Participating Provider Organization] dentist, Ameritas will add a PPO Bonus amount to their annual reward. PPO dentists help members save by providing care at discounted rates. PPO and PPO bonus are available in most states.

Dental Rewards Example

Annual maximum for Type 1, 2 & 3 (Preventive, Basic, Major) Annual dental reward (carryover) toward next benefit year Annual PPO bonus (if applicable) toward next benefit year Next benefit year’s annual maximum + dental reward + PPO

$ 1,500 $ 250

+ $ 150

$ 1,900

In this example, the annual benefit threshold amount is $750. Members must keep benefits received at or below this amount to earn rewards. Their annual maximum benefit can increase up to $2,500 total. The annual maximum includes Type 4 (Select) procedures when applicable.

Available Plan Options

Annual Benefit Threshold

Annual Maximum

Annual Dental Reward

Annual PPO Bonus

Maximum Reward Accumulation

$ 500

$ 250

$ 125

$ 50

$ 500

550 750 850

250 250 250 500 500 500 500 750 750 750

125 125 125 250 250 250 250 250 400 400

50 50 50

500 500 500

1,000 1,200 1,250 1,500 1,500 1,750 2,000

100 100 100 150 150 200 200

1,000 1,000 1,000 1,000 1,000 1,200 1,200

Other annual maximum options may be available. Dental Rewards applies to Type 1, 2, 3 and 4 [Preventive, Basic, Major and Select] dental procedures.

This information is provided by Ameritas Life Insurance Corp. [Ameritas Life]. Group dental, vision and hearing care products [9000 Rev. 03-08, dates may vary by state] and individual dental and vision products [Indiv. 9000 Ed. 11-09] are issued by Ameritas Life. Some plan designs are not available in all areas. In Texas, our PPO network and plans are referred to as the Ameritas Dental Network. Some states require that producers be appointed with Ameritas Life before soliciting its products. To become appointed with Ameritas Life, please call 800-659-2223. Most plans for groups with 26 or more enrolled lives are administered by Ameritas Life. Billing and eligibility for most plans with 25 or fewer enrolled lives are provided by HealthPlan Services, Inc.

Ameritas, the bison symbol, and company names designated with SM or ® are service marks or registered service marks of Ameritas Life or Ameritas Mutual Holding Company. © 2013 Ameritas Mutual Holding Company.

800-776-9446 ameritasgroup.com