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Dental - District of Columbia
Freestanding Preferred (PPO), Traditional, BlueDental Plus, BlueDental EPO & BlueDental Basic
Group Size | Group Subscriber Enrollment Form | Group Contract Application |
---|---|---|
2-50 (Grandfathered/Non-ACA) | CUT5153 | N/A |
2-50 Freestanding (not certified ACA benchmark plans; benefits include dental services for adults and children)
|
SUM2709 | DC/GHMSI/POE (1/13) (for plans effective prior to 5/1/19) DC/GHMSI/DN-VS ONLY/GCA (R. 11/18) (for plans effective 5/1/19 and after) |
51+ Freestanding (not certified ACA benchmark plans; benefits include dental services for adults and children)
|
SUM2709 | DC/GHMSI/GCA/LG (1/14) (BP, HB(PPO), & DN-VS Only) (for plans effective prior to 5/1/19) DC/GHMSI/DN-VS ONLY/GCA (R. 11/18) (for plans effective 5/1/19 and after) |