Forms & publications

This chart briefly compares the per-visit costs of some in-network benefits for PEBB plans. Some copays and coinsurance do not apply until after you have paid your annual deductible. For information on specific benefits and exclusions, refer to the dental plan’s certificate of coverage or contact the plan.

This document outlines costs and coverage details for PEBB dental plans. If anything in this document conflicts with the plan’s benefits book, the benefits book takes precedence.