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Dental Plan
 

Good oral health is part of your total health picture. It’s not just about pearly whites and fresh breath; healthy teeth can help you maintain a healthy body. Please remember, you can visit any dentist you choose, however if you choose a network dentist you will not be required to pay any over reasonable and customary charges.

Dental SBC

Find a provider

To obtain a list of dentists participating in your Delta Dental network simply go to www.deltadental.com or call 800.335.8266

Dental Coverage
In-Network
Orthodontia Lifetime Max
$1,500
Calendar year deductible
$75 per person / $225 per family
Type I - Diagnostic and preventative services (oral exams, teeth cleaning, X-rays, etc.)
100%
Type II - Basic services (ancillary, fillings, extractions, etc.)
80%
Type III - Major services (oral surgery, crowns, dentures, etc.)
80%
Calendar year maximum benefit
$1,500 per person
Bi-Weekly Employee Rates
Employee
$14.24
Employee + Spouse
$28.17
Employee + Child(ren)
$28.07
Family
$47.83

Group Number

Network

Carrier Website

Customer Service Number

Premier

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52787

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