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.
The Delta Dental plan offers both a preferred provider dental plan and an HMO dental plan. You may choose to enroll in the Preferred Provider Organization (PPO) plan or the HMO plan.
- PPO – If you choose the preferred provider plan, that means that the “participating dentists” have agreed to participate in Delta Dental’s Preferred Provider Organization program (PPO). They have agreed to provide insured persons with dental care at a negotiated fee and take responsibility for obtaining any treatment authorizations required under the plan.
Click here to learn more about the Delta Dental PPO plan.
- HMO – The HMO dental plan option was created with the idea of delivering quality dental care without requiring claim forms, no deductibles, and no annual maximum. As long as you see your HMO (panel dentist) there is no cost for covered services except for copays on certain procedures. You will need to select a primary care dentist who will manage all of your dental care.
Click here to learn more about the Delta Dental HMO plan.
Dental PPO
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$1,500
Preventive Care
$0
Basic Services
20% after deductible
Major Procedures
50% after deductible
Orthodontia (up to age 26)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived
Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Maximum
$1,500
Preventive Care
30%
Basic Services
30% after deductible
Major Procedures
50% after deductible
Orthodontia (up to age 26)
50% up to a lifetime maximum benefit of $1,500 per individual; deductible waived
Plan Cost – SEIU Bargaining Unit Employees
Employee
Employee Only: $3.16
Employee + 1 Dependent: $5.76
Employee + Family: $9.78
Employer
Employee Only: $17.91
Employee + 1 Dependent: $32.57
Employee + Family: $55.44
Plan Cost – CNA Bargaining Unit and Non-Bargaining Employees
Employee
Employee Only: $4.22
Employee + 1 Dependent: $7.67
Employee + Family: $13.04
Employer
Employee Only: $16.85
Employee + 1 Dependent: $30.66
Employee + Family: $52.18
Dental HMO
Benefit Highlights
In-Network
Deductible (Individual/Family)
None
Annual Plan Maximum
None
Preventive Care
Up to $15 copay
Basic Services
Up to $200 copay
Major Procedures
Up to $160 copay
Orthodontia (Adults/Children)
Up to $1,800 copay / Up to $1,600 copay Up to age 19
Plan Cost – SEIU Bargaining Unit Employees
Employee
Employee Only: $1.49
Employee + 1 Dependent: $2.45
Employee + Family: $3.62
Employer
Employee Only: $8.42
Employee + 1 Dependent: $13.90
Employee + Family: $20.55
Plan Cost – CNA Bargaining Unit and Non-Bargaining Employees
Employee
Employee Only: $1.98
Employee + 1 Dependent: $3.27
Employee + Family: $4.84
Employer
Employee Only: $7.92
Employee + 1 Dependent: $13.08
Employee + Family: $19.33