Preferred Provider Plan Dental Service Areas

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Barnstable County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Aetna Leap Dental PPO	AL IVL CB-HDentalPol 05
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
American General Life Ins. Co. ¹	Group Dental PPO Plan	G-DEN-42000 MA
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc	Altus Dental For Small Group Business	AD200-GPRX (MA)
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
The Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA (07/17)
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Dental Service of Massachusetts, Inc.	Delta Dental Preferred	DDP-PPA1
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dental Service of Massachusetts, Inc.	DeltaCare USA	SP151-FDS
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	DeltaCare	DSM.MA.DeltaCare.Ind.Sub.Cert.01.15 & Grp.Sub
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Renaissance Life and Health Ins. Co. of America	Renaissance Massachusetts Group Dental Certificate	D-2102A-2014-MA, D-202A & D-201A-2014-MA
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
UniCARE Life and Health Insurance Company	Wellpoint Dental PPO	GCR 130, 3119-31127
Union Security Insurance Company	Dental Group Certificate	GC-90 et al
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹ Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² The Lincoln National Life Insurance Company notified the Division on July 7, 2011 that effective October 1, 2011 the originally approved dental network [Connection Dental Network] will be replaced by the Dental Benefit Provider Network.
³ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

^*Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Berkshire County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
Dearborn National Life Insurance Company	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/Carrington Maximum Care Network	INVD-100A
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
Union Security Insurance Company	Dental Group Certificate	GC-90 et al
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316

¹ Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
³ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Bristol County Preferred Provider Plan Dental Service

Dental Insured Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Aetna Leap Dental PPO	AL IVL CB-HDentalPol 05
Aetna Life Insurance Company	Advantage Plus	MA-DMO
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
CIGNA Health and Life Insurance Company	CIGNA Dental PPO	HP-POL63 et. Al
CIGNA Life and Health Insurance Company	CIGNA Individual Dental PPO	HC-NOT11 et. al./HC-CER33
Dearborn National Life Insurance Company ²	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
Humana Insurance Company	Dental PPO	MA-70146-HC 1/14
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Renaissance Life and Health Ins. Co. of America	Renaissance Massachusetts Group Dental Certificate	D-2102A-2014-MA, D-202A & D-201A-2014-MA
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Starmount Life Insurance Company	Group Dental w/DenteMax	DN-2015GRPCT-MA
Sun Life Assurance Company of Canada	Dental PPO [w Aetna Dental Access®]	GC-A-1 et al.
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
UniCARE Life and Health Insurance Company	Wellpoint Dental PPO	CGR 130
Union Security Insurance Company ³	Dental Group Certificate	GC-90 et al.
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹ Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
3Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
⁴ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Dukes County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc	Altus Dental Preferred	AD 1
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co. of Delaware ¹	Group Dental PPO Plan	G-DEN-42000 MA
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GL12 Series
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316

¹Effective December 8, 2009, AIG Life Insurance Company changed its name to American General Life Insurance Company of Delaware.
² Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
³Effective March 24, 2006, company changed its name from GE Group Life Assurance Company to Genworth Life and Health Insurance Company.

Essex County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Aetna Leap Dental PPO	AL IVL CB-HDentalPol 05
Aetna Life Insurance Company	Advantage Plus	MA-DMO
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
CIGNA Health and Life Insurance Company	CIGNA Dental PPO	HP-POL63 et. Al
CIGNA Health and Life Insurance Company	CIGNA Individual Dental PPO	HC-NOT11 et. al./HC-CER33
Dearborn National Life Insurance Company ²	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Dental Preferred	DDP-PPA1
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dental Service of Massachusetts, Inc.	DeltaCare USA	SP151-FDS
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	DeltaCare	DSM.MA.DeltaCare.Ind.Sub.Cert.01.15 & Grp.Sub
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
Humana Insurance Company	Dental PPO	MA-70146-HC 1/14
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ DenteMax Network	INVD-100A
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Renaissance Massachusetts Group Dental Certificate	D-2102A-2014-MA, D-202A & D-201A-2014-MA
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Starmount Life Insurance Company	Group Dental w/DenteMax	DN-2015GRPCT-MA
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
UniCARE Life and Health Insurance Company	Wellpoint Dental PPO	CGR 130
Union Security Insurance Company ³	Dental Group Certificate	GC-90 et al.
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
³Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
4 Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Franklin County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc	Delta Dental PPO Individual National	DDP-PPA6
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
Fort Dearborn Life Insurance Company	Group Dental Insurance	7P-100-1004
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]

¹Effective December 8, 2009, AIG Life Insurance Company changed its name to American General Life Insurance Company of Delaware.
² The Lincoln National Life Insurance Company notified the Division on July 7, 2011 that effective October 1, 2011 the originally approved dental network [Connection Dental Network] will be replaced by the Dental Benefit Provider Network.
³Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
⁴ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.
^*Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Hampden County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Advantage Plus	MA-DMO
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
CIGNA Health and Life Insurance Company	CIGNA Dental PPO	HP-POL63 et. Al
CIGNA Health and Life Insurance Company	CIGNA Individual Dental PPO	HC-NOT11 et. al./HC-CER33
Dearborn National Life Insurance Company ²	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Dental Preferred	DDP-PPA1
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dental Service of Massachusetts, Inc.	DeltaCare USA	SP151-FDS
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Renaissance Life and Health Ins. Co. of America	Renaissance Massachusetts Group Dental Certificate	D-2102A-2014-MA, D-202A & D-201A-2014-MA
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
Union Security Insurance Company	Dental Group Certificate	GC-90 et al.
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
³ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Hampshire County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
Dearborn National Life Insurance Company ²	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
Union Security Insurance Company	Dental Group Certificate	GC-90 et al
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
³ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Middlesex County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Aetna Leap Dental PPO	AL IVL CB-HDentalPol 05
Aetna Life Insurance Company	Advantage Plus	MA-DMO
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
CIGNA Health and Life Insurance Company	CIGNA Dental PPO	HP-POL63 et. Al
CIGNA Health and Life Insurance Company	CIGNA Individual Dental PPO	HC-NOT11 et. al./HC-CER33
Dearborn National Life Insurance Company ²	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Dental Preferred	DDP-PPA1
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dental Service of Massachusetts, Inc.	DeltaCare USA	SP151-FDS
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	DeltaCare	DSM.MA.DeltaCare.Ind.Sub.Cert.01.15 & Grp.Sub
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
Humana Insurance Company	Dental PPO	MA-70146-HC 1/14
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Renaissance Life and Health Ins. Co. of America	Renaissance Massachusetts Group Dental Certificate	D-2102A-2014-MA, D-202A & D-201A-2014-MA
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Starmount Life Insurance Company	Group Dental w/DenteMax	DN-2015GRPCT-MA
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Sun Life and Health Insurance Company ⁴	Dental PPO [DenteMax Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
UniCARE Life and Health Insurance Company	Wellpoint Dental PPO	CGR 130
Union Security Insurance Company ⁵	Dental Group Certificate	GC-90 et al.
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹Effective December 8, 2009, AIG Life Insurance Company changed its name to American General Life Insurance Company of Delaware.
2 Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
³ The Lincoln National Life Insurance Company notified the Division on July 7, 2011 that effective October 1, 2011 the originally approved dental network [Connection Dental Network] will be replaced by the Dental Benefit Provider Network.
⁴Effective December 1, 2007, Genworth Life and Health Insurance Company changed its name to Sun Life and Health Insurance Company.
⁵Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
⁶ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Nantucket County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co. of Delaware ¹	Group Dental PPO Plan	G-DEN-42000 MA
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta

¹Effective December 8, 2009, AIG Life Insurance Company changed its name to American General Life Insurance Company of Delaware.
²Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
³Effective March 24, 2006, company changed its name from GE Group Life Assurance Company to Genworth Life and Health Insurance Company.

Norfolk County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Aetna Leap Dental PPO	AL IVL CB-HDentalPol 05
Aetna Life Insurance Company	Advantage Plus	MA-DMO
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
CIGNA Health and Life Insurance Company	CIGNA Dental PPO	HP-POL63 et. Al
CIGNA Health and Life Insurance Company	CIGNA Individual Dental PPO	HC-NOT11 et. al./HC-CER33
Dearborn National Life Insurance Company ²	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	DeltaCare	DSM.MA.DeltaCare.Ind.Sub.Cert.01.15 & Grp.Sub
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
Humana Insurance Company	Dental PPO	MA-70146-HC 1/14
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 100 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Renaissance Life and Health Ins. Co. of America	Renaissance Massachusetts Group Dental Certificate	D-2102A-2014-MA, D-202A & D-201A-2014-MA
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Starmount Life Insurance Company	Group Dental w/DenteMax	DN-2015GRPCT-MA
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
UniCARE Life and Health Insurance Company	Wellpoint Dental PPO	CGR 130
Union Security Insurance Company ³	Dental Group Certificate	GC-90 et al.
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
³Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
⁴ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Plymouth County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Aetna Leap Dental PPO	AL IVL CB-HDentalPol 05
Aetna Life Insurance Company	Advantage Plus	MA-DMO
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
CIGNA Health and Life Insurance Company	CIGNA Dental PPO	HP-POL63 et. Al
CIGNA Life and Health Insurance Company	CIGNA Individual Dental PPO	HC-NOT11 et. al./HC-CER33
Dearborn National Life Insurance Company ²	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Dental Preferred	DDP-PPA1
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc	Delta Dental PPO Individual National	DDP-PPA6
Dental Service of Massachusetts, Inc	DeltaCare USA	SP151-FDS
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	DeltaCare	DSM.MA.DeltaCare.Ind.Sub.Cert.01.15 & Grp.Sub
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
Humana Insurance Company	Dental PPO	MA-70146-HC 1/14
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Renaissance Life and Health Ins. Co. of America	Renaissance Massachusetts Group Dental Certificate	D-2102A-2014-MA, D-202A & D-201A-2014-MA
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Starmount Life Insurance Company	Group Dental w/DenteMax	DN-2015GRPCT-MA
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
UniCARE Life and Health Insurance Company	Wellpoint Dental PPO	CGR 130
Union Security Insurance Company ³	Dental Group Certificate	GC-90 et al.
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
³Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
⁴ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Suffolk County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Advantage Plus	MA-DMO
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
CIGNA Health and Life Insurance Company	CIGNA Dental PPO	HP-POL63 et. Al
CIGNA Health and Life Insurance Company	CIGNA Individual Dental PPO	HC-NOT11 et. al./HC-CER33
Dearborn National Life Insurance Company ²	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Dental Preferred	DDP-PPA1
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dental Service of Massachusetts, Inc.	DeltaCare USA	SP151-FDS
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	DeltaCare	DSM.MA.DeltaCare.Ind.Sub.Cert.01.15 & Grp.Sub
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental Plan Certificate of Insurance	MA-70146-HD 1/09 et al.
Humana Insurance Company	Dental PPO	MA-70146-HC 1/14
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 100 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Renaissance Life and Health Ins. Co. of America	Renaissance Massachusetts Group Dental Certificate	D-2102A-2014-MA, D-202A & D-201A-2014-MA
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Starmount Life Insurance Company	Group Dental w/DenteMax	DN-2015GRPCT-MA
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
UniCARE Life and Health Insurance Company	Wellpoint Dental PPO	CGR 130
Union Security Insurance Company ³	Dental Group Certificate	GC-90 et al.
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
³Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
⁴Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

Worcester County Preferred Provider Plan Dental Service

DENTAL Insured Preferred Provider Plans	Product Name	Form Number
Aetna Life Insurance Company	Aetna Leap Dental PPO	AL IVL CB-HDentalPol 05
Aetna Life Insurance Company	Advantage Plus	MA-DMO
Aetna Life Insurance Company	Dental PPO	MA-Dental PPO
Aetna Life Insurance Company	Advantage Plus	MA-DMO Copay Plans
Altus Dental Insurance Company, Inc.	Altus Dental Preferred	AD 1 v.4
Altus Dental Insurance Company, Inc.	Altus Dental Preferred - AAA Members	AD 3C
Altus Dental Insurance Company, Inc.	Altus Dental Value Option Plan 1	AD 5
Altus Dental Insurance Company, Inc.	Altus Dental For 1	AD100-IND (MA)
Altus Dental Insurance Company, Inc.	Altus Dental Individual	AD200-INDX (MA)
Altus Dental Insurance Company, Inc.	Altus Dental For Small Group Business	AD200-GPRX (MA)
American General Life Ins. Co.¹	Group Dental PPO Plan	G-DEN-42000 MA
Ameritas Life Insurance Corp.	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 1	DENT PPO1
Blue Cross and Blue Shield of Massachusetts, Inc.	Dental Blue PPO Program 2	DENT PPO2
Chesapeake Life Insurance Company	PPO Dental Plan	CH-26121-IP (01/12) MA
CIGNA Health and Life Insurance Company	CIGNA Dental PPO	HP-POL63 et. Al
CIGNA Health and Life Insurance Company	CIGNA Individual Dental PPO	HC-NOT11 et. al./HC-CER33
Dearborn National Life Insurance Company ²	Group Dental Insurance	7C-100-1004-MA R608
Dental Service of Massachusetts, Inc.	Delta Care	DDP-PPA2
Dental Service of Massachusetts, Inc.	Delta Dental PPO	Options- SP001; SP030; SP032; SP034; SP035; SP036
Dental Service of Massachusetts, Inc.	Delta Dental PPO Individual National	DDP-PPA6
Dentegra Insurance Company	Dentegra Group PPO	G-SLE-E-MA-09
Dentegra Insurance Company	Delta Dental PPOSM for Ind. & Families	I-SLE-C-MA-09
Dentegra Insurance Company	Dentegra Individual PPO Plan	I-PPO-C-MA-12
Dentegra Insurance Company	Dentegra Group PPO Plan	G-PPO-E-MA-09
Dentegra Insurance Company of NE	AARP Dental Insurance Plan	CC-DNNE-MA(DELTAUSA1-2005)D
DSM Massachusetts Insurance Company, Inc.	Delta Dental Individual and Family EPO	DDEPO.SubcInd. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Small Group	DDEPO.SubcGrp. 06-14
DSM Massachusetts Insurance Company, Inc.	Delta Dental EPO Group MA - Off Exchange	DDEPO.Non-ACA.SubcGrp.09-14-14 & MA.EPO.BPR.09.2014
DSM Massachusetts Insurance Company, Inc.	Total Choice PPO	DD.TCPPO.GRP.LOCAL.012017
First Health Life and Health Insurance Company	Dental PPO with DentalGuard Network	MHBP01C-MA 0911
(The) Guardian Life Insurance Company of America	DentalGuard Preferred	CGP-3-DNTL-90-1 et al.
(The) Guardian Life Insurance Company of America	Individual Dental Policy - DentalGuard Preferred	IP-DEN-12-MA
Humana Insurance Company	Dental PPO	MA-70146-HC 1/14
The Lincoln National Life Insurance Company	Group Dental Insurance	GL11/GS12 Series
Metropolitan Life Insurance Company	Individual Dental Policy	IND-DENTAL-2015 & FSD (retiree option)
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	G.23000-13E-MA1
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Classic	GCERT2000 den/classic
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	G.23000-13E-MA2
Metropolitan Life Insurance Company	MetLife Preferred Dentist Program - Value	GCERT2000 den/value
Metropolitan Life Insurance Company	PDP Copay Plan	G.23000-13EMA3
Metropolitan Life Insurance Company	PDP Copay Plan	GCERT2000 den/copayrc
MONY Life Insurance Company of America	Group Dental Insurance	MOEBC15
Principal Life Insurance Company	Group Voluntary Dental Expense PPO Plan	GC 7000 A (DPPO) et al.
Principal Life Insurance Company	Group Dental Expense Ins. Ind/PPO	GC 7100
Reliance Standard Life Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Renaissance Life and Health Ins. Co. of America	Renaissance Non-EHB Individual Dental Policy	INVD-100A-2016-MA
Renaissance Life and Health Ins. Co. of America	Dental PPO Plan w/ Delta Dental Network	INVD-100A-Delta
Renaissance Life and Health Ins. Co. of America	Renaissance Massachusetts Group Dental Certificate	D-2102A-2014-MA, D-202A & D-201A-2014-MA
Standard Insurance Company	Certificate Group Dental [and Eye Care] Insurance	9021 MA Rev. 04-13
Starmount Life Insurance Company	Group Dental w/DenteMax	DN-2015GRPCT-MA
Sun Life Assurance Company of Canada	Dental PPO [United Concordia Network]	GC-A-1 et al.
Trustmark Insurance Company	Group Dental	VD0106T/C
UniCARE Life and Health Insurance Company	Wellpoint Dental PPO	CGR 130
Union Security Insurance Company ³	Dental Group Certificate	GC-90 et al.
United Concordia Insurance Company	Concordia Preferred w Advantage Plus 2.0	MA9804-B (06/17); 9808 0316/9806 0316
United Concordia Insurance Company	Concordia Preferred w Elite Plus network	MA9804-B (06/17); 9808 0316/9806 0316
United HealthCare Insurance Company	Dental Certificate of Coverage	DCOC.CER.06 AZ [Rev. 1/06]
United of Omaha Life Insurance Company	Group Dental	12345GCB-DEN-EZ 13 MA

¹Effective December 31, 2012, American General Life Insurance Company of Delaware merged into American General Life Insurance Company.
² Effective March 1, 2012, Fort Dearborn Life Insurance Company's name changed to Dearborn National Life Insurance Company
³Effective September 6, 2005, Fortis Benefits Insurance Company changed its name to Union Security Insurance Company.
⁴ Effective December 31, 2016, Security Life Insurance Company of America (“Security Life”) merged into Ameritas Life Insurance Corp (“Ameritas”). Effective January 1, 2017, the Security Life Complete and Advantage Plus plans were no longer marketed in Massachusetts.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - American General Life Insurance Company (Form#G-DEN-42002-MA), (The) Principal Life Insurance Company - Dental PPO - Classic & Premier Design (Form# GH 100A (DPPO), Group Voluntary Dental Expense PPO Plan (Form# GC 2000), Insurance PPO Plan (Form# GC 7000) , Group Dental Expense (Form# GC 7200) and United Concordia Insurance Company - Individual Dental Plans (Form#'s MAIN01-0312UCIC & MAIN01-0310UCIC).

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