Dental
Our Plan provides coverage for a broad array of services through Delta Dental of New Jersey, the nation's largest dental network. Delta provides routine preventive exams and cleanings twice a year, and offers some coverage for orthodontia and dentures. There are no overall limits for Active Members, and Delta pays up to $1,000 a year per family for Retired Members. Our Delta Dental Group # is 4634.
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Active
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Retiree
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Calendar Year Deductible
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None
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None
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Plan Pays:
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Plan Pays:
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Preventive & Diagnostic
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100%
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100%
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Remaining Basic
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60%
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60%
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Crowns & Prosthodontics
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60%
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60%
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TMJ (Non Surgical Only)
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40%
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40%
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Active Participants Implants ($1,200 maximum per person per year)
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40%
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N/A
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Retiree Participants Implants ($1,000 maximum per family per year)
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N/A
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40%
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Annual Family Maximum for Retired Adults Only
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N/A
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$1,000
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TMJ Lifetime Maximum
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$500
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$500
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Orthodontia (Adults & Children)
**Cleanings associated with medical conditions are not capped at 2 for coverage |
$1,200
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$1,200
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Dependent children (unmarried or married) are covered to age 26 (provided the child is NOT eligible for health coverage under a plan sponsored by their own employer or, if married, their spouse's employer).
Delta Dental has two networks available under this plan. The Delta Dental Premier® network is the largest of the Delta Dental networks with over 213,000 participating dentist offices nationally (75%+). Delta Dental PPOSM is a smaller, but more discounted network with over 134,000 participating dentist offices nationwide. Delta Dental PPOSM fees are on average 20% less than Delta Dental Premier®. You may use any fully licensed dentist under this plan, but it is to your advantage to use a network dentist, especially PPO, since they accept the Delta Dental allowance as their maximum charge and cannot bill Delta Dental patients for amounts above this level.
Participating dentists will be paid directly by Delta Dental for covered services. Non-participating dentists will bill you directly, and Delta Dental will make claim payment directly to you. You will maximize benefits and reduce paperwork by using a Delta Dental participating dentist.
If you do not have a dentist, you may obtain a current listing of participating dentists in any area, by calling 1-800 DELTA OK (1-800-335-8265). Provide your zip code to the representative and a directory for that area will be mailed to your home. If you have Internet access, you may also visit our website at deltadentalnj.com to locate participating dentists.
At the time of your first appointment, tell the dentist that you are covered under this program and provide your group number and ID number. Your dependents, if covered, should provide the employee’s ID number.
Claim questions and other information needs should be directed to Delta Dental’s customer service department at 1-800-452-9310.