Delta Dental PPO Plus Premier

 

Delta Dental is a fee for service plan.  The Delta Dental plan pays for basic coverage and prosthodontic coverage (dentures, bridges, retainers) based on your plan coverage (with no deductible) when using a participating Delta Dental dentist.

You may use a dentist outside of the network, but if you submit a claim from a non-network dentist, Delta will only pay the fees approved by Delta.  A dentist outside of the network may charge more than Delta’s “usual & customary” fee, and if so, you will have to pay the extra portion of the fee not covered by Delta.

Delta Dental does not provide ID cards, so your provider will look you up by your SSN.

Please see below for plan breakdowns based on your union. Review your Evidence of Coverage (EOC) for more details.  

Administrative Employees (AFSCME, SEIU, TAEA, Non-Represented)	Deductible	Plan Coverage	Maximum (per individual)
Basic & Prosthodontic	N/A	75%	$3,000/year
Orthodontic	N/A	60%	$3,000/lifetime
Group Number	Group Number: 03533-00013

 

ATU Employees	Deductible	Plan Coverage	Maximum (per individual)
Basic & Prosthodontic	N/A	90%	$1,500/year
Orthodontic	N/A	60%	$1,000/lifetime
Group Number	Group Number: 03533-00011