
Delta Dental
- https://www1.deltadentalins.com
- 800-521-2651
- $2,000 or $2,500 benefit coverage
- Two preventive basic cleanings each year at no cost
- Basic and major dental services coverage
- Providers nationwide on the Delta Dental PPO and Premier networks
- Orthodontia benefits on the Dental Plus plan
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Dental (2000) Summary Plan Description |
Dental Plus (2500) Summary Plan Description |
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Services |
Contracted Dentist |
Non-Contracted Dentist |
Contracted Dentist |
Non-Contracted Dentist |
Preventive |
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Routine exams, cleanings (2 per year), topical fluoride, x-rays, space maintainers, sealants |
100% |
100% of R&C |
100% |
100% of R&C |
Basic |
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Composite fillings, extractions, oral |
80% |
80% of R&C |
80% |
80% of R&C |
Major |
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Crowns, bridges, dentures, surgical |
50% |
50% of R&C |
50% |
50% of R&C |
Orthodontics |
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Lifetime Maximum |
No Benefit |
No Benefit |
$2000 |
$2000 |
Maximum Benefit (Applies to Basic and Major Services Per Benefit Period) |
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Benefit Period is Per Calendar Year |
$2,000 |
$2,500 |
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Deductible (Per Benefit Period) |
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Per Person: |
$50.00 |
$50.00 |
$50.00 |
$50.00 |
Specialists |
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Contracted Specialist payment: |
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Non-contracted Specialist payment: |
Paid the same as non-contracted dentists |
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Contracted Specialist payment: |
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Non-contracted Specialist payment: |
Paid the same as non-contracted dentists |
2024 | Full Time | Part Time |
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Monthly | Monthly | |
Dental (2000) |
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Single | $10 | $20 |
Two party | $22 | $35 |
Family | $29 | $45 |
Dental Plus (2500) |
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Single | $28 | $40 |
Two party | $64 | $102 |
Family | $86 | $127 |
2024 | ||
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Dental 2000 (Cost per month) |
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Employee | $36 | |
Employee + 1 Child | $81 | |
Employee + Spouse | $81 | |
Employee + Children | $107 | |
Employee + Family | $107 | |
Dental Plus 2500 (Cost per month) |
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Employee | $48 | |
Employee + 1 Child | $109 | |
Employee + Spouse | $109 | |
Employee + Children | $147 | |
Employee + Family | $147 |
If you have any difficulty reading the documents linked below, you may be able to get a copy in your preferred language. Please call: 1-866-530-9675
Delta Dental