MDA Health Plan for dental offices
Retain and protect your employees with the MDA Health Plan
What would make you feel valued and protected as an employee? To retain and protect your employees, you treat them like family. Be the employer you would want to work for, and the hero to your staff. Did you know that quality health care coverage is the highest ranked benefit workers value most beyond income and compensation for all age categories?* Offering health insurance has proven to enhance recruitment and retention of employees. That’s where we come in. As an MDA member, you get exclusive access to the #1 member benefit, and your key solution to recruitment and retention: The MDA Health Plan. We’ve got you covered.
What makes the MDA Health Plan so special?
√ Exclusively for MDA members, their families and staff.
√ Every plan includes fertility benefits, gym memberships and TruHearing benefits.
√ Family Focus and Living Fit plans are available, too!
√ Affordable, quality care.
√ Created by dentists, for dentists.
√ PPO and HSA options.
√ 11 plans to choose from–pick up to three for your practice!
√ Flexible plan for every budget.
√ Member-centric customer service is top priority.
√ Offering the MDA Health Plan to your employees does not mean you have to contribute to the cost. You may contribute any amount or % of the cost you wish, or may require employees to pay 100% of the cost.
Plan Designs
Click below to view the 2024 plan overview guide:
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In the chart below, the SBC is the Summary of Benefits and Coverage. The BAAG is the plan’s Benefits-at-a-Glance. Click on the acronyms to download the PDF and view the information.
2023 Preferred Provider Organization (PPO) Plans
| In-Network Amounts | |||
| Plan Name | Deductible | Co-Pay | Total Out-of-Pocket |
| Simply Copay PPO (Plan 0) SBC BAAG |
$0 Single/ $0 Two-Person/ $0 Family
Prescriptions: $10 generic/ $20 non-preferred generic / 50% preferred ($100 max)/ 50% non-preferred ($300 max) / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max) |
$0 Office Visit $75 Specialist $75 Urgent Care $500 E.R. (waived if admitted) |
$8,700 / $13,875 / $17,400 |
| Living Fit PPO (Plan 11) SBC BAAG |
$3,000 Single/ $4,500 Two-Person/ $6,000 Family
Prescriptions: $10 generic/ $20 non-preferred generic / 50% preferred ($100 max)/ 50% non-preferred ($300 max) / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max); LEARN MORE > |
$30 Office Visit $45 Specialist $50 Urgent Care $100 E.R. 20% coinsurance |
$8,700 / $13,875 / $17,400 |
| Premier Elite PPO (Plan 1) SBC BAAG |
$500 Single/ $1,000 Two-Person/ $1,500 Family
Prescriptions: $10 generic/ $20 non-preferred generic / $50 preferred brand/ $100 non-preferred brand / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max) |
$30 Office Visit $60 Specialist $35 Urgent Care $100 E.R. 20% coinsurance |
$8,700/ $13,875/$17,400 |
| Elite PPO (Plan 2) SBC BAAG |
$1,000 Single/ $2,000 Two-Person/ $3,000 Family
Prescriptions: $10 generic/ $20 non-preferred generic / $50 preferred brand/ $100 non-preferred brand / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max) |
$30 Office Visit $45 Specialist $35 Urgent Care $100 E.R. 20% coinsurance |
$8,700/ $13,875/$17,400 |
| Select PPO (Plan 3) SBC BAAG |
$1,500 Single/ $3,000 Two-Person/ $4,500 Family
Prescriptions: $10 generic/ $20 non-preferred generic / $60 preferred brand/ $120 non-preferred brand / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max) |
$35 Office Visit $70 Specialist $35 Urgent Care $100 E. R. 20% coinsurance |
$8,700/ $13,875/$17,400 |
| Classic Plus PPO (Plan 4) SBC BAAG |
$2,500 Single/ $5,000 Two-Person/ $7,500 Family
Prescriptions: $10 generic/ $20 non-preferred generic / $60 preferred brand/ $120 non-preferred brand / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max) |
$35 Office Visit $55 Specialist $35 Urgent Care $100 E. R. 20% coinsurance |
$8,700/ $13,875/$17,400 |
| Family Focus PPO (Plan 8) SBC BAAG |
$3,000 Single/ $4,500 Two-Person/ $4,500 Family Prescriptions: $10 generic/ $20 non-preferred generic / $60 preferred brand/ $120 non-preferred brand / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max) |
$20 Office Visit $40 Specialist $50 Urgent Care $100 E. R. 20% coinsurance |
$8,700/ $17,400/$17,400 |
| Advanced Value (Plan 10) SBC BAAG |
$7,150 Single/ $12,500 Two-Person/ $14,300 Family
Prescriptions: $10 generic / $20 non-preferred generic / 50% preferred brand (max $100) / 50% non-preferred brand (max $300) / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max) |
$35 Office Visit $70 Specialist $100 E.R. $50 Urgent Care |
$8,700/ $13,875/$17,400 |
The plans below are qualified for health savings accounts (HSA). Fund your HSA with pre-tax dollars to reduce your taxable income and pay for eligible medical and vision expenses. Unexpended funds accrue from year to year and can be used to pay for health care in retirement.
2023 High-Deductible/HSA Health Plans
| In-Network Amounts | |||
| Plan Name | Deductible | Co-Pay | Total Out-of-Pocket |
| Living Fit HSA (Plan 12) SBC BAAG |
$3,000 Single $6,000 family |
20% coinsurance Prescriptions: $10 generic/ $20 non-preferred generic / $60 preferred brand/ $120 non-preferred brand / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max); LEARN MORE > |
$7,050 Single $14,100 Two-Person $14,100 Family |
| Elite HSA (Plan 5) SBC BAAG |
$2,000 Single $4,000 family |
20% coinsurance Prescriptions: $10 generic/ $20 non-preferred generic / $60 preferred brand/ $120 non-preferred brand / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max) |
$7,050 Single $14,100 Two-Person $14,100 Family |
| Family Focus HSA (Plan 6) SBC BAAG |
$3,000 Single $6,000 family |
20% coinsurance Prescriptions: $10 generic/ $20 non-preferred generic / $60 preferred brand/ $120 non-preferred brand / 20% preferred specialty ($200 max) / 50% non-preferred specialty ($500 max) |
$7,050 Single $14,100 Two-Person $14,100 Family |
Living Fit Health Plan: LEARN MORE >
Family Focus Health Plan: LEARN MORE >
Plan Documents
Various regulations require the documents below to be made available to MDA Health Plan sponsors and employees. Documents may be downloaded and saved or printed. Adobe Acrobat Reader is required to access these documents. You may access a free download of Acrobat Reader by clicking here.
PPO Plans
Schedule of Medical Benefits:
- Simply Copays PPO (Plan 0)
- Premier Elite PPO (Plan 1)
- Elite PPO (Plan 2)
- Select PPO (Plan 3)
- Classic Plus PPO (Plan 4)
- Family Focus PPO (Plan 8)
- Advanced Value (Plan 10)
- Summary Plan Description for Plans 1-4, 8, and 10
High-deductible Health Plans (HSA)
Schedule of Medical Benefits:
Employer Financial Obligation Notice
The members who participate in the self-insured MDA Health Plan ultimately are responsible for paying claims. The state of Michigan requires language to be included in the participation agreement that states members understand they could be assessed up to four months of contributions to cover shortfalls if necessary.
- If the employer ceases to participate in the MDA Health Plan, it continues to be liable to the health plan trust for its proportionate share of any assessment made by the Michigan Insurance Commission for benefits paid during the previous calendar year.
- If the cash reserves of the Trust and Plan are less than required by Michigan, participating employers will be liable for up to four months of contingent premiums should the plan’s Trustees demand it during the time the employer participates in the plan and for the one-year period after participation in the plan terminates.
- While this possibility exists, it is remote. The MDA Health Plan is using an actuary to project claims based on historic and anticipated utilization. The state of Michigan reviews and actuarial analysis for reasonableness and accuracy. These actuarial projections of plan expenses are used to build the rates to provide adequate contributions from members.
- Another factor that makes it unlikely that an assessment would be required is MDA Insurance’s 30-plus years of successfully administering its individual health plan, which required the negotiation of rates to ensure the adequate collection of funds to cover claims.
MDA Insurance does not endorse any financial institution for Health Savings Accounts.
All MDA Health Plan designs are powered by Priority Health. Participating providers and facilities are part of the multi-tier networks used by Priority Health. Claims are administered on behalf of the MDA Health Plan by Priority Health. MDA Insurance can provide assistance with any claim questions or subscriber service needs.
Subscriber Service Contact Information:
MDA Insurance: 877.906.9924 Mon.- Fri. 8 a.m. – 5 p.m.
Priority Health: 800.956.1954 Mon. – Thurs. 7:30 a.m. – 7 p.m.; Fri. 9 a.m. to 5 p.m., Sat. 8:30 a.m. to 12 Noon
