Delta Dental Individual-Basic PPO Pediatric Essential Health Benefit - 99708NJ0120020 Health Insurance Plan
99708 health insurance plan with the Plan ID 99708NJ0120020. The plan is called Delta Dental Individual-Basic PPO Pediatric Essential Health Benefit.
| Health Insurance Plan ID | 99708NJ0120020 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2023 | ||||||||||||||||||
| State | New Jersey | ||||||||||||||||||
| Health Insurance Issuer | 99708 | ||||||||||||||||||
| Health Insurance Plan Variant | 99708NJ0120020-01 | ||||||||||||||||||
| Provider Network(s) | ['NJN002'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Tue, 07 May 2024 06:08 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Mon, 23 Jan 2023 00:00 GMT | ||||||||||||||||||
| Last Import Date | Tue, 07 May 2024 06:08 GMT |
Delta Dental Individual-Basic PPO Pediatric Essential Health Benefit Health Insurance Plan Variant 99708NJ0120020-01 Attributes
| Plan Attribute | Value |
|---|---|
| Business Year | 2023 |
| Child-Only Offering | Allows Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Low On Exchange Plan |
| Dental Only Plan | Yes |
| EHB Apportionment for Pediatric Dental | 100% |
| First Tier Utilization | 100% |
| HIOS Product ID | 99708NJ012 |
| Import Date | 1/23/2023 |
| Guaranteed Rate | Guaranteed Rate |
| IsItANewPlan | Existing |
| Issuer ID | 99708 |
| Market Coverage | Individual |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out Network, Family | per person not applicable | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Combined In/Out | Not Applicable |
| Medical EHB Deductible, Combined In/Out of Network, Family | $135 per person | $405 per group |
| Medical EHB Deductible, Combined In/Out of Network, Individual | $135 |
| Medical EHB Deductible, In Network (Tier 1), Family | $135 per person | $405 per group |
| Medical EHB Deductible, In Network (Tier 1), Individual | $135 |
| Medical EHB Deductible, Out of Network, Family | $135 per person | $405 per group |
| Medical EHB Deductible, Out of Network, Individual | $135 |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Family | $350 per person | $700 per group |
| Maximum Out of Pocket for Medical EHB Benefits, In Network (Tier 1), Individual | $350 |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Family | per person not applicable | per group not applicable |
| Maximum Out of Pocket for Medical EHB Benefits, Out of Network, Individual | Not Applicable |
| Metal Level | Low |
| Multiple In Network Tiers | No |
| National Network | Yes |
| Network ID | NJN002 |
| Out of Country Coverage | No |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | Coverage is available throughout the United States |
| Plan Effective Date | 1/1/2023 |
| Plan Expiration Date | 12/31/2023 |
| Plan ID (Standard Component ID with Variant) | 99708NJ0120020-01 |
| Plan Marketing Name | Delta Dental Individual-Basic PPO Pediatric Essential Health Benefit |
| Plan Type | PPO |
| Plan Variant Marketing Name | Delta Dental Individual-Basic PPO Pediatric Essential Health Benefit |
| QHP/Non QHP | Both |
| Service Area ID | NJS001 |
| Source Name | SERFF |
| Plan ID | 99708NJ0120020 |
| State Code | NJ |
| Version Number | 1 |
| Wellness Program Offered | No |
Copay & Coinsurance of Delta Dental Individual-Basic PPO Pediatric Essential Health Benefit Health Insurance Plan, 99708NJ0120020
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about Delta Dental Individual-Basic PPO Pediatric Essential Health Benefit, 99708NJ0120020 Health Insurance Plan, 99708NJ0120020
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Does Delta Dental Individual-Basic PPO Pediatric Essential Health Benefit Health Insurance Plan, 99708NJ0120020 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (99708NJ0120020) Health Insurance Plan, Variant (99708NJ0120020-01) have Out Of Country Coverage?
No, unfortunately there
is no Out Of Country Coverage for this Health Insurance Plan
(variant of plan).
Does (99708NJ0120020) Health Insurance Plan, Variant (99708NJ0120020-01) have Out of Service Area Coverage?
Yes. Details: Coverage is available throughout the United States
Disclaimer: This is based on the import(Date: Tue, 07 May 2024 06:08 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API