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 PPO
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$1,500
Preventive Care
$0
Basic Services
50% after deductible
Major Procedures
50% after deductible
Orthodontia (Dependent Children up to age 26)
50% up to a lifetime maximum benefit of $1,000 per individual; deductible waived
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$1,500
Preventive Care
$0
Basic Services
50% after deductible
Major Procedures
50% after deductible
Orthodontia (Dependent Children up to age 26)
50% up to a lifetime maximum benefit of $1,000 per individual; deductible waived
Plan Cost
Employee Only: $2.47
Employee and Spouse/DP: $13.69
Employee and Child(ren): $16.84
Employee and Family: $23.09