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Dental Insurance
Benefit
Summaries
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All information provided is
in summary format. For complete details of
coverage, exclusions, limitations, etc., please refer
to the summary plan document, certificate or master
contract, not this online summary.
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Delta
Dental USA |
Subject to Calendar
Year Deductible (CYD) of $50 per individual up to $150 Family Cap |
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Calendar Year Maximum |
All dental services
subject to $1,500 per Individual maximum |
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Preventative
Services |
100% of Eligible
Expenses (deductible waived) paid - (Exam Visits, X-rays, 2
cleanings per year) |
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Basic Services |
80% of Eligible
Expenses paid - (Fillings, extractions, periodontal treatment) |
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Major Services |
50% of Eligible
Expenses paid - (Crowns, bridges, dentures) |
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