Welcome School Employees Benefits Board (SEBB) Program Members

 

You have chosen the Uniform Dental Plan (UDP)

GROUP #09600

UNIFORM DENTAL PLAN
 
You pick your dentist from the largest provider networks: state and national
Get specialist care without a referral
Deductible waived for preventive care-you pay $0
Deductible & coinsurance apply for other treatments
Deductible & coinsurance apply for other treatments
Coverage for out-of-network care
Responsive, local customer service
 

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

STEP 1
Activate your MySmile® account
Easy, secure access to all your custom dental benefit information on your phone or desktop!
 
View and print your ID card
View your custom coverage overview, claim status and benefits usage
Get instant out-of-pocket estimates on your dentist and your plan
Review your Explanation of Benefits (EOB)
See how much of your annual maximum you have left to spend
And more
 
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
 
Find a Dentist Tool
Select 'Delta Dental PPO' to filter your search results
Contact the dental office to confirm they're accepting new patients
 
STEP 3
Review your DeltaCare® costs
ANNUAL COSTS
 
Deductible
(amount you pay before your plan pays)
  $50 / person
$150 / family
Plan maximum
(amount your plan pays towards the cost of your dental care during the plan year)
  $1,750
 
YOU PAY AFTER DEDUCTIBLE
 
Cleaning and exam every 6 months   0%
Fluoride treatment   0%
Complete x-rays every 3 years   0%
Fillings   20%
Crowns   50%
Root canals (endodontics)   20%
Treatment of gum disease (periodontics)   20%
Tooth extractions   20%
Dentures   50%
Implants   50%
Orthodontics   50% until you reach lifetime annual maximum of $1750; patient is responsible for any amount exceeding the liftime annual maximum
Nonsurgical TMJ   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)
This is a summary of UDP plan benefits. Please review the PEBB UDP certificate of coverage below for more information about your plan.
certificate of coverage