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A Nationwide Dental PPO Plan

Authorized for distr ibution by the: Healthcare and Insurance Blue Cross Blue Shield FEP DentalSM 1-855-504-2583 2022 A Nationwide Dental PPO Plan IMPORTANT Rates: Back Cover Summary of Benefits: Page 48 Who may enroll in this Plan: All Federal employees, annuitants, and certain TRICARE beneficiaries in the United States and overseas who are eligible to enroll in the Federal Employees Dental and Vision Insurance Program. Enrollment Options for this Plan: High Option Self Only High Option Self Plus One High Option Self and Family Standard Option Self Only Standard Option Self Plus One Standard Option Self and Family This Plan has 6 enrollment regions, including international; please see the end of this brochure to determine your region and corresponding ratesIntroduction On December 23, 2004, President George W.

offering the same type of coverage; i.e., you (or covered family members) cannot be covered by two FEDVIP dental plans or two FEDVIP vision plans. Dual Enrollment. If you sign up for a dental and/or vision plan during the 2021 Open Season, your coverage will begin on January 1, 2022. Premium deductions will start with the first full pay period

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