DENTAL BENEFIT OPTIONS
Fully-paid dental coverage is provided for you and your dependents. You have two dental plans to select from: Delta Dental and Delta Care USA (formerly known as PMI). The coverage varies for both of these plans;
Delta Dental will cover you at 70% the first year on the plan and will increase 10% each year based on usage. The Delta plan allows you freedom of choice in selecting your dental office.
Delta Care USA (formerly known as PMI) requires you to select a dental office from the listing. Services can only be provided by the office you have selected.
|
Delta Dental |
DeltaCare USA |
|
|---|---|---|
|
Annual Benefit Maximum |
$2,500 |
There is no benefit maximum limit. |
|
Co-payment for Basic Exam, X-ray, Preventive, Diagnostic, and Restorative Services |
70%/30% - first year; |
100% Coverage. Enrollee pays nothing. |
|
Crowns, Jackets, and Cast Restorations |
70%/30% - first year; |
100% Coverage. Enrollee pays nothing for basic dental procedures. See summary of benefits. There is a cost for high noble metal crowns. |
|
Prosthodontics |
50% |
100% Coverage. Enrollee pays nothing for basic dental procedures. See summary of benefits. There is a cost for dentures. |
|
Dental Services in Case of an Accident |
100% Coverage; $1,000 separate maximum |
100% Coverage of the contract dentist filed fees up to a maximum of $1,600 in a 12 month period. |
|
Orthodontia |
For dependents to age 25 regardless of student status. There is 50% Coverage - $500 lifetime maximum. |
$350 start-up fee; |
For a brief highlight of coverage select one of the above links. For detailed information please refer to your benefits booklet or contact Sharleen Carlos in Human Resources (562) 860-2451 Ext. 2280