Dental
Dental coverage helps you maintain a healthy smile with preventive care, basic services, and major procedures. You can visit any licensed dentist, but you’ll save the most when you use an in-network provider who has agreed to discounted rates. Out-of-network dentists may charge more than the plan’s allowed amount, and you may be responsible for the difference. Most plans cover preventive services—such as exams, cleanings, and X-rays—at 100% when you stay in-network, making regular checkups an easy way to protect your oral health and avoid costly issues.
Delta Dental HMO
Benefit Highlights
In-Network
Deductible
$0
Annual Plan Maximum
Unlimited
Preventive Care
$0
Basic Services
Payment based on copay schedule
Major Procedures
Payment based on copay schedule
Orthodontia (Adults and Children)
Child: $1,700 copay / Adult: $1,900 copay
Bi-Weekly Plan Cost
Employee Only: $4.14
Employee and Spouse/DP: $10.75
Employee and Child(ren): $10.63
Employee and Family: $19.33
Delta Dental PPO Base
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$1,750
Preventive Care
$0
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
Not covered
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$1,750
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (Adults and Children)
Not covered
Bi-Weekly Plan Cost
Employee Only: $8.31
Employee and Spouse/DP: $23.91
Employee and Child(ren): $32.72
Employee and Family: $48.33
Delta Dental PPO Buy-Up
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$3,000
Preventive Care
$0
Basic Services
$0 after deductible
Major Procedures
30% after deductible
Orthodontia (Adults and Children)
50%
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$3,000
Preventive Care
$0
Basic Services
10% after deductible
Major Procedures
40% after deductible
Orthodontia (Adults and Children)
50%
Bi-Weekly Plan Cost
Employee Only: $15.23
Employee and Spouse/DP: $37.41
Employee and Child(ren): $49.91
Employee and Family: $72.11