Welcome Public Employees Benefits Board (PEBB) Members
You have chosen the Uniform Dental Plan (UDP)
GROUP #03000
UNIFORM DENTAL PLAN |
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You pick your dentist from the largest provider networks: state and national |
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Get specialist care without a referral |
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Deductible waived for preventive care-you pay $0 |
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Deductible & coinsurance apply for other treatments |
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Deductible & coinsurance apply for other treatments |
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Coverage for out-of-network care |
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Responsive, local customer service |
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COINSURANCE: On the UDP (PPO) plan, you pay a percentage of treatment costs, the plan pays the rest.
Here's how to get the most from your coverage
Easy, secure access to all your custom dental benefit information on your phone or desktop! |
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View and print your ID card |
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View your custom coverage overview, claim status and benefits usage |
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Get instant out-of-pocket estimates on your dentist and your plan |
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Review your Explanation of Benefits (EOB) |
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See how much of your annual maximum you have left to spend |
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And more |
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STEP 2
Find a Delta Dental PPO dentist to get the best savings
Check that your dentist is in-network or find a new PPO dentist |
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Find a Dentist Tool |
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Select 'Delta Dental PPO' to filter your search results |
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Contact the dental office to confirm they're accepting new patients |
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STEP 3
Review your UDP® costs
ANNUAL COSTS |
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Deductible
(amount you pay before your plan pays) |
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$50 / person
$150 / family |
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Plan maximum
(amount your plan pays towards the cost of your dental care during the plan year) |
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$1,750 |
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YOU PAY AFTER DEDUCTIBLE |
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Cleaning and exam every 6 months |
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0% |
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Complete x-rays every 3 years |
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0% |
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Root canals (endodontics) |
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20% |
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Treatment of gum disease (periodontics) |
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20% |
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Orthodontics |
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50% until you reach lifetime annual maximum of $1750; patient is responsible for any amount exceeding the liftime annual maximum |
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Nonsurgical TMJ |
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30% of costs until the plan has paid $500 (for PPO, out of state, and non-PPO providers); then any amount over $500 in the member's lifetime (maximum lifetime benefit) |
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This is a summary of UDP plan benefits. Please review the PEBB UDP certificate of coverage below for more information about your plan. |