- Underwritten by Delta Dental Insurance Company
- Free choice of dentist
- Plan Maximum of $1,000 per person, per calendar year
- Benefits increase after the first and second years
- 6 month waiting period for basic procedures
- 12 month waiting period for major procedures
- $50 deductible per person, per calendar year
Benefit Association Disclaimer
One time Non Refundable Processing fee: $35.00
The stated rates above include a four dollar ($4) per month billing fee, a four percent (4%) administration fee, and one dollar ($1) per month fee for membership in the Benefits Association. Membership in the Benefits Association, Inc. is required to enroll in this plan. Should you decide to enroll in this dental plan, you will be prompted during the enrollment process to confirm your acceptance of membership in the Benefits Association. If you are already a member of Benefits Association, please call the member services number located on the back of your membership card, and they will process your enrollment accordingly. Should your effective date fall on, or between, December 1st and May 1st, your policy will renew in December of each year, at which time rates may be subject to change. After your first renewal, the rates will be guaranteed for 12 months each year thereafter. If your effective date is on or between June 1st and November 1st, your policy will renew in June of each year, at which time rates may be subject to change. After your first renewal, the rates will be guaranteed for 12 months each year thereafter.
|Description||Plan Pays Year 1||Plan Pays Year 2||Plan Pays Year 3|
|Diagnostic and Preventive Procedures||Diagnostic: Routine periodic examinations twice in a calendar year. Preventative: Dental prophylaxis (teeth cleaning) twice in a calendar year. Radiography: Bitewing and full mouth x-rays.||60%||80%||100%|
|Basic Procedures (6 month waiting period)||Restorative: Amalgam fillings. Other: Space maintainers, recementation of crowns.||50%||65%||80%|
|Major Procedures (12 month waiting period)||Endodontics: Pulpal therapy and root canals. Periodontics: Treatment of diseases of the gums. Oral Surgery: Extractions and other oral surgery, including pre and post operative care. Prosthetics: Gold restorations, crowns, bridges, partials and complete dentures. Other: Pontics, repair of crowns and bridges, repair of full and partial dentures.||0%||30%||50%|
|Orthodontia||This plan does not have any benefits for orthodontia.||0%||0%||0%|
- $50 per person per calendar year.
- Office Co-Pay
Methods of Payment
- American Express
Yes. There are some limitations and exclusions with this plan, as with most group insurance policies. For a brief summary of the limitations and exclusions click here.