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Delta Dental PPO℠ Plan


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Delta Dental PPO℠ Plan Options

Delta Dental of Washington Benefit Highlights:

  • Covers up to four periodontal cleanings a year under certain qualifying periodontal circumstances
  • Periodontic cleaning and maintenance covered under Class I
  • Endodontics (root canals) and Surgical Periodontics (root planing and scaling) covered under Class II
  • Fluoride and sealant coverage for both children and adults including bicuspids
  • Deductible waived for Class I services
  • Class I services do not accumulate toward the calendar year annual maximum
  • No “missing tooth clause” or pre-existing conditions
  • No late entrant provisions or waiting periods
  • TMJ coverage included - $1,000 annual maximum and $5,000 lifetime maximum
  • Dependents eligible for benefits through age 25

Underwriting Guidelines:


Eligibility

  • Coverage available to employees who work a minimum of 80 hours each calendar month or as otherwise determined by the group

Contributions

  • Employer must contribute at least 50 percent of the employee premium.
  • Employer contribution toward the dependent premium is not required.

Participation

  • Employee participation for groups with 5 to 9 enrolled subscribers is 100 percent of all eligible employees or tied to the company’s medical plan.
  • Dependent participation for groups with 5 to 9 enrolled subscribers is 100 percent of all eligible dependents.
  • Employee participation for groups with 10 to 99 enrolled subscribers is 75 percent enrollment of all eligible employees.
  • Dependent participation for groups with 10 to 99 enrolled subscribers is 50 percent enrollment of all eligible dependents.

Rate Guarantee

  • One-year rate guarantee

Click here to view PDF version of information above. Please contact your Sales Executive for groups with 100 or more enrolled subscribers for plan options.

 

Questions?  Click Here to find contacts and system information.