Your dental insurance is provided by Delta Dental. You are encouraged to utilize in-network Delta Dental providers. By using an in-network provider, you can save money on dental procedures. If you choose to visit a provider that is not in the PPO network, you may be balance billed if your provider charges more than what is considered to be reasonable and customary for the services provided.
The information contained in this presentation is an overview of your benefits. If you have specific questions regarding a provider or procedure, please call Delta Dental Customer Service at (800) 335-8266 or refer to the Dental SPD.
Delta Dental Benefits
|
In-Network (Delta Dental Providers) |
|
|
Deductible (Waived on Preventive) |
|
| Single |
$50 |
| Family |
$150 |
|
Calendar Year Max (Per Member) |
$1,500 |
|
Class 1 - Preventive Services (Routine Oral Exams, Prophylaxis) |
100% |
|
Class 2 - Basic Services (Fillings, Endodontics, Simple Extractions) |
80% |
|
Class 3 - Major Services (Crowns, Bridges, Dentures) |
50% |
|
Ortho Coverage (Child & Adult) |
50% up to $1,500 Lifetime Max |
Dental Plan Payroll Deductions
|
Semi-Monthly |
Monthly |
|
|
Employee Only |
$3.17 | $6.34 |
|
Employee + Child(ren) |
$9.81 | $19.62 |
|
Employee + Spouse |
$8.22 | $16.45 |
|
Family |
$14.87 | $29.74 |
Finding Dental Providers
How do you find a Delta Dental PPO provider?
It's easy! There are several ways!!
- Contact your provider and ask:
"Do you participate in the Delta Dental PPO Network?" - Contact Delta Dental at the toll-free number:
1 (800) 335-8266 - Visit them on the Internet at:
www.deltadentalsc.com
