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Human Resources - Dental Benefits

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
(formerly known as PMI)

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;
80%/20% - second year;
90%/10% - third year;
100% - fourth year and after

100% Coverage. Enrollee pays nothing.

Crowns, Jackets, and Cast Restorations

70%/30% - first year;
80%/20% - second year;
90%/10% - third year;
100% - fourth year and after

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;
$1,300 fee for children to age 19.
$1,600 fee for adults ages 19 and older.

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

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Last Update: 4/10/2008