Hybrid Plan photo

An option that allows you to move between the dental hmo and ppo plans as your needs change

Choice in Plan Type:

The Cypress Hybrid plan allows you to select either a Dental Health Maintenance Organization (DHMO) managed care plan or a
Dental Preferred Provider Organization (PPO) plan.

Flexibility to Change Plans:

With the Cypress Hybrid plan, you may switch from the DHMO to the PPO plan or vice versa throughout the year. You and your
dependents must be enrolled in the same plan type, either DHMO or PPO. If you decide to switch between plans, simply send a
secure email to cypresshybrid@cypressadmin.com or contact our Customer Service Department at 800-350-3989. If the change
request is made by the 15th of any month, the change will become effective the first of the following month. Note: Plan changes
may only be requested by the employee or the employer on behalf of the employee.

Benefits:

  • Choose the DHMO plan and you will generally have less of an out-of-pocket expense and get the greatest level of coverage.
  • Choose the PPO plan and enjoy the freedom to choose any dentist. Get the greatest level of PPO coverage by choosing one of
    our Preferred Provider Network dentists.
  • Switch between plans every month or stay in the plan you initially selected. The choice is yours.

How the Program works:

First, you choose which plan you want to enroll in: DHMO or PPO. See our online directory at www.cypressadmin.com for
participating providers in our DHMO Network or our Preferred Provider Network.
Once enrolled, follow the rules of your plan (DHMO or PPO). During the year, you are free to switch between the two plans.
To request a plan change simply send a secure email to cypresshybrid@cypressadmin.com or contact our Customer Service
Department at 800-350-3989 by the 15th of the month to make your change effective the first of the following month. Remember,
you and your dependents must be enrolled in the same plan.

Your Covered Dental Services

Your Cypress Hybrid plan design offers you coverage for a broad
range of dental services in both the DHMO and PPO plan options,
including:

  • Preventive Services (exams, cleanings and x-rays). The DHMO
    plan includes additional cleanings and adult fluoride (up to
    age 18).
  • Basic Services (fillings, stainless steel crowns and extractions).
    The DHMO plan includes coverage for posterior composites
    (white fillings on back teeth).
  • Major Services (crowns, bridges and dentures). The DHMO plan
    includes coverage for specific cosmetic procedures, nitrous
    oxide, certain mouth guards, and more

What is not Covered?

Below is a partial list of the charges and services the Cypress Hybrid
plan does not cover. For a complete list of exclusions and limitations,
see your plan documents.

  • Dental services that are primarily cosmetic in nature (except
    as specified in the DHMO plan).
  • Experimental services, supplies or procedures.
  • Treatment of any jaw joint disorder, such as temporomandibular
    joint dysfunction (TMJ) (except as specified in the
    DHMO plan or if your plan sponsor has included additional
    coverage).
  • Replacement of lost, missing or stolen appliances and
    damaged appliances.
  • Services that are not dentally necessary for diagnosis, care or
    treatment.
  • All other limitations and exclusions included in your plan
    documents.

Specific Covered Services and Supplies may fall under a different category than what is stated above. Age and frequency limits may apply to some services. Refer to your Schedule of Benefits for details on benefit levels and covered services.