What’s My Rate?

To determine the appropriate premium rates for a Dental plan:

  • Look up yur state of residence
  • Look up your 3-digit zip code
  • Use the Area # that applies to your state/zip to determine
    the premium rate from the table below.
State First 3 Digits of Zip Code Area

Alabama

350-354, 362-364, 367-369

1

355-361, 365-366

2

Alaska

Not Available

6

Arizona

850-857

2

859-865

3

Arkansas

2

California

923-925

2

900, 905-922, 926-938, 952-953, 955-961

3

901-904, 939, 945-946, 948, 950-951

4

940-944, 947, 949, 954

5

Colorado

3

Connecticut

4

Delaware

197, 199

4

198

5

D.C.

3

Florida

320-322, 325-329, 334-338, 342-349

2

323-324, 333, 339-341

3

330-332

4

Georgia

306-310, 312, 319

2

300-305, 311, 313-318, 398

3

Hawaii

3

Idaho

2

Illinois

624, 628-629

1

609-623, 625-627

2

600-608

3

Indiana

471, 475

1

460-462, 465-470, 472-474, 476-479

2

463-464

3

Iowa

508-510, 512-516

1

500-507, 520-528

2

511

3

Kansas

2

Kentucky

400-404, 406-409, 411-419, 425-427

1

405, 410, 420-424

2

Louisiana

2

Maine

Not Available

3

Not Available

4

Maryland

215

1

206, 210-214, 216-219

2

207-209

3

Massachusetts

010, 012-013

3

011, 014-027

4

Michigan

486

2

480-485, 487-499

3

Minnesota

3

Mississippi

2

Missouri

645

1

630-644, 646-651, 653-659

2

652

3

Montana

Not Available

3

Nebraska

680-684, 689-690

1

685-688, 691-693

2

Nevada

889-891

2

893-898

4

New Hampshire

Not Available

4

Not Available

5

New Jersey

071-072

2

070, 073, 077, 080-087

3

074-076, 078-079, 088-089

4

New Mexico

Not Available

3

New York

104, 124-129, 133-136, 142

2

103, 109-110, 115, 117-123, 130-132

3

137-141, 143-149

3

063, 105-108, 111-114, 116

4

100-102

6

North Carolina

Not Available

3

Not Available

4

North Dakota

3

Ohio

430-435, 437-459

2

436

3

Oklahoma

731, 735-749

2

730, 734

3

Oregon

3

Pennsylvania

Not Available

1

Not Available

2

Not Available

2

Not Available

3

Puerto Rico

1

Rhode Island

 

3

South Carolina

3

South Dakota

570, 572-577

2

571

3

Tennessee

2

Texas

782

1

754-759, 764-769, 773-774, 776-781, 783-785

2

788-789, 794-799

2

750-753, 760-763, 770-772, 775, 786-787

3

790-793, 885

3

Utah

Not Available

1

Vermont

Not Available

4

Virginia

Not Available

2

Not Available

3

Virgin Islands

3

Washington

990-992, 994

3

985-989, 993

4

980-984

5

West Virginia

2

Wisconsin

3

Wyoming

2

HIGH PLAN
Area 1 2 3 4 5 6
Member Only $31.21 $34.78 $42.27 $45.37 $47.80 $51.54
Member + Spouse $63.13 $73.31 $84.23 $90.42 $96.42 $104.97
Member + Child(ren) $75.50 $87.69 $100.74 $108.14 $115.32 $125.54
Member + Family $113.45 $135.07 $153.53 $168.11 $178.31 $192.64
LOW PLAN
Area 1 2 3 4 5 6
Member Only $24.32 $26.30 $29.53 $31.52 $32.51 $34.49
Member + Spouse $45.44 $49.66 $58.85 $63.32 $64.78 $69.78
Member + Child(ren) $49.76 $54.38 $64.44 $69.33 $71.51 $76.40
Member + Family $81.91 $91.66 $100.24 $109.11 $116.80 $125.37

 

For a list of primary covered services & limitations, please download a plan summary.