 |
These are brief descriptions of the available dental plans. Please consult each carrier's "Evidence of Coverage" booklet or call the carrier for a more detailed explanation.
PREPAID DENTAL PLANS
DeltaCare USA (formerly PMI) and SafeGuard
These plans provide dental services through member dentists throughout California. (State-sponsored prepaid dental plans are not available outside of California.)
The monthly premiums are fully paid by the State. Enrollees have no monthly premiums, deductibles, or maximum benefit limits. Many services are provided at low or no cost to you. You may change dentists upon request and/or change plans if you move and your plan is no longer available. If you need emergency dental work and are outside your service area (50 miles from your residence), you may go to any dentist for the relief of pain and be reimbursed up to $400 per calendar year. For more information or a list of each plan's member dentists, contact the carriers at:
| DeltaCare USA
|
1-800-422-4234
|
| SafeGuard Health Plans, Inc.
|
1-800-880-1800
|
INDEMNITY DENTAL PLAN
DeltaPremier - Group #9949
DeltaPremier features full access to specialty care and guaranteed benefits through member dentists. However, you can see any dentist worldwide and still be covered, although your out-of-pocket costs may be higher.
If you are a represented employee in Bargaining Units 1, 3, 4, 9, 10, 11, 12, 13, 14, 15, 20, or 21, the amount deducted from your paycheck each month is:
| Coverage
|
2007
|
2008
|
| Party Code 1 (yourself only)
|
$ 11.74
| $ 12.02
|
| Party Code 2 (yourself plus one dependent)
|
$ 20.68
|
$ 21.28
|
| Party Code 3 (yourself plus two or more dependents)
|
$ 30.00
|
$ 30.94
|
If you are in Bargaining Unit 2, 7, 8, 16, 17, 18, or 19, you are in Consolidated Benefits and the full premium amount will be deducted from your benefit allowance.
For more information, contact Delta Dental at 1-800-225-3368 or visit www.deltadentalca.org/state.
PREFERRED PROVIDER OPTION DENTAL PLAN
Delta Preferred Provider Option (PPO) - Group #9946
The Preferred Provider Option (PPO) provides services through its network of participating dentists although you may use non-PPO dentists worldwide. If you receive services outside the PPO network, your out-of-pocket costs will be substantially higher. Therefore, you are encouraged to contact Delta Dental before enrolling to ensure there is a PPO provider available in your service area. (Not all Delta Dentists are members of the PPO network.)
For represented employees, the annual maximum benefit available to dependents is $2,000 when using a dentist who is a member of the PPO network, compared to a $1,000 yearly maximum under DeltaPremier. The PPO plan offers a $2,500 lifetime benefit for dental implants and a third cleaning for high-risk patients. Generally, high-risk patients include pregnant women, cancer chemotherapy patients, persons with compromising systemic diseases such as diabetes, AIDS, or endocarditis, and persons who have had organ transplants.
If you are a represented employee in Bargaining Units 1, 3, 4, 9, 10, 11, 12, 13, 14, 15, 20, or 21, the amount deducted from your paycheck each month is:
| Coverage
|
2007
|
2008
|
| Party Code 1 (yourself only)
|
$ 10.12
|
$ 10.22
|
| Party Code 2 (yourself plus one dependent)
|
$ 19.86
|
$ 20.16
|
| Party Code 3 (yourself plus two or more dependents)
|
$ 29.97
|
$ 30.50
|
If you are in Bargaining Unit 2, 7, 8, 16, 17, 18, or 19, you are in Consolidated Benefits and the full premium amount will be deducted from your benefit allowance.
For more information, contact Delta Dental at 1-800-225-3368 or visit www.deltadentalca.org/state.
|
 |