Dental coverage provides benefits for preventive care like exams and cleanings. It also covers basic and major restorative care. The Company offers you two dental options administered by Delta Dental of Illinois*, or you can decline coverage:
Both options cover the same services, but the Buy-up option has a higher calendar year maximum — that is, the amount the plan will pay in one year — and covers orthodontia services. The following chart provides a summary of your dental coverage.
|Calendar year maximum (excludes orthodontia)||$1,500 per person||$2,000 per person|
|Orthodontia lifetime maximum||No benefit||$2,000 per person|
|Annual deductible you pay|
|Individual||$50 per person||$50 per person|
|Family||$150 per family||$150 per family|
|Coinsurance you pay|
|Preventive and diagnostic care (exams, cleanings, x-rays, etc.)||$0 (100% covered)||$0 (100% covered)|
|Basic restorative care (fillings, endodontics, periodontics, oral surgery, etc.)||20%||20%|
|Major restorative care (crown, bridge, denture, implant, etc.)||50%||50%|
|Orthodontia care — for adults and children||No benefit||50% (PPO provider) 50% of Maximum Plan Allowance (Premier provider or out-of-network)|
Delta Dental Networks
While you can visit any general or specialty dentist, you pay less for care when you use a provider in one of the Delta Dental
* If you live in Puerto Rico, your dental coverage is administered by Triple S (Blue Cross and Blue Shield of Puerto Rico). You will receive a separate insert regarding coverage details and cost.