Page 10 - Cornerstone Systems New Hire Guide
P. 10
Beneit Guide
Delta Dental
of Tennessee Delta Dental of Tennessee Dental Insurance
Dental Maintaining healthy teeth and gums and seeking professional treatment
Insurance when dental problems arise is important to your overall health.
Associates and their families should maintain good dental habits and
seek professional dental care. Our chosen dental provider is Delta
Dental of Tennessee. Visit www.toolkitsonline.com to ind a dentist
and understand your dental beneits.
Premier/Non-
PPO Dentists participating
Dentist
Calendar Year Deductible
Individual $50 $50
Family $150 $150
Calendar Year Maximum $1,500 $1,500
Coinsurance
Preventive 100% 100%
Basic 90% 80%
Major 60% 50%
Orthodontia
Coinsurance 50% 50%
Lifetime Maximum $1,500 $1,500
Beneit applies to Children (up to age 19)
Diagnostic and Preventive
Visit for oral examination 100% 100%
Fluoride 100% 100%
Sealants—to prevent decay of permanent 100% 100%
teeth
X-Rays
One set of bite-wing x-rays are covered in a 100% 100%
12-month period
Full mouth x-rays are covered once every 100% 100%
ive years
Basic Services
Minor restorative services—ilings 90% 80%
Endodontic services—root canals 90% 80%
Oral surgery services—extractions and 90% 80%
dental surgery
Periodontics services—to treat gum disease 90% 80%
Major Services
Crown repair—to individual crowns 60% 50%
Major restorative services—crowns 60% 50%
Prosthodontic services—bridges, implants, 60% 50%
and dentures
10
Delta Dental
of Tennessee Delta Dental of Tennessee Dental Insurance
Dental Maintaining healthy teeth and gums and seeking professional treatment
Insurance when dental problems arise is important to your overall health.
Associates and their families should maintain good dental habits and
seek professional dental care. Our chosen dental provider is Delta
Dental of Tennessee. Visit www.toolkitsonline.com to ind a dentist
and understand your dental beneits.
Premier/Non-
PPO Dentists participating
Dentist
Calendar Year Deductible
Individual $50 $50
Family $150 $150
Calendar Year Maximum $1,500 $1,500
Coinsurance
Preventive 100% 100%
Basic 90% 80%
Major 60% 50%
Orthodontia
Coinsurance 50% 50%
Lifetime Maximum $1,500 $1,500
Beneit applies to Children (up to age 19)
Diagnostic and Preventive
Visit for oral examination 100% 100%
Fluoride 100% 100%
Sealants—to prevent decay of permanent 100% 100%
teeth
X-Rays
One set of bite-wing x-rays are covered in a 100% 100%
12-month period
Full mouth x-rays are covered once every 100% 100%
ive years
Basic Services
Minor restorative services—ilings 90% 80%
Endodontic services—root canals 90% 80%
Oral surgery services—extractions and 90% 80%
dental surgery
Periodontics services—to treat gum disease 90% 80%
Major Services
Crown repair—to individual crowns 60% 50%
Major restorative services—crowns 60% 50%
Prosthodontic services—bridges, implants, 60% 50%
and dentures
10
