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