LifeMap

LifeMap Dental Rates

You may enroll for Dental Only Coverage. All members must be enrolled for the same coverage and premium payment schedule. These rates are effective July 1, 2018 through September 30, 2018.

LifeMap Individual Incentive 10 Dental Plan
Monthly Premium Per Member
Age Range Dental Only
Under 18 $ 36.98
18-64 $ 57.89
65+ $ 62.33
Quarterly Premium Per Member
Age Range Dental Only
Under 18 $110.94
18-64 $173.67
65+ $186.99

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LifeMap Individual Dollar-Based Dental Plan
Monthly Premium Per Member
Age Range Dental Only
Under 18 $49.83
18-64 $62.22
65+ $69.18
Quarterly Premium Per Member
Age Range Dental Only
Under 18 $149.49
18-64 $186.66
65+ $207.54

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LifeMap Individual Exclusive Provider Organization 16
Monthly Premium Per Member
Family Status Dental Only
Individual $50.02
Ind. & 1 Dependent $102.01
Family $153.29
Quarterly Premium Per Member
Family Status Dental Only
Individual $150.06
Ind. & 1 Dependent $306.03
Family $459.87

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