Search below for the plan name and out-of-network reimbursement type (INFS or U&C) listed on your quote. The name of each document corresponds to the display of the product on your quote.

Dental Plan Name_Coins % (in)_Coins % (out)_ Deductible Single_Annual Maximum

Summary of Dental Benefits

SDBC (Humana LS100) Small/Large Group

SDBC (Humana LS200) Small/Large Group

SDBC (Humana LS300) Small/Large Group

Benefit Schedule

LS100 Humana Benefit Schedule CDT24

LS200 Humana Benefit Schedule CDT24

LS300 Humana Benefit Schedule CDT24

Need help?

If you would prefer a paper version of your Summary of Dental Benefits and Coverage (SDBC) document, call us at 800-232-2006 (TTY: 711). We are available Monday – Friday, 7 a.m. – 7 p.m., Eastern time