About Your Benefits
Dental Insurance - Delta Dental
www.nedelta.com and 800-537-1715
Phone App available
Group #62777
The coverage selected for your dental benefits plan uses Delta Dental’s PPO and Premier networks of Participating Dentists. This Delta Dental network plan allows you to go to any Dentist of your choice and receive a level of benefits for covered services, but you will receive the best value from your plan if you visit a network Dentist. Please reference the Dental Summary Plan Description for more information.
Basic coverage outline:
- Diagnostic - 100% covered
- Preventative - 100% covered
- Basic Restorative – 80% covered after deductible
- Major Restorative – 50% covered after deductible
- Orthodontic – 50% covered, maximum $1,500
- Deductibles - $50 Individual/ $150Family
- Annual Maximum - $1500, not including orthodontics
Premiums:
Coverage | Semi-Monthly Cost |
---|---|
Full-Time Regular Part-Time | |
Team Member Only | $ 5 $ 6.50 |
Team Member & Child(ren) | $22 $ 25 |
Team Member & Spouse | $22 $ 25 |
Team Member & Family | $44 $ 47 |