Page 11 - Benefits Summary/New Hire Enrollment Guide
P. 11
Voluntary Dental Insurance
Amy Chakravadhanula Lara Rice
In 2020-2021 Northern Human Services will continue to offer a 100% employee paid dental plan benefit
through Delta Dental to those employees working 20+ hours per week. New employees are eligible for
voluntary dental insurance on the first of the month following 60 days of employment.
Explanation of Dental Benefits
Preventive Services
Covered at 100% Exams, cleanings, x-rays, sealant applications and oral cancer screenings
Deductible
Applies to basic and major • $25 individual
services only • $75 family
Basic Services
Covered at 80% Fillings (including white fillings on anterior and posterior teeth), simple extractions,
6-Month Waiting Period includes periodontics and endodontics
Major Services
Covered at 50%
12-Month Waiting Period Dentures, crowns, inlays, implants
Orthodontia
Covered at 50% • $1500 lifetime max per patient
24-Month Waiting Period • for dependent children to age 19
Annual Maximum $1500 per person per plan year
Below is a breakdown of your pre-tax contribution for the 2020-2021 plan year.
Employee Plus
Employee Only One Family
Weekly
Deduction $10.76 $19.55 $33.35
Bi-Weekly
$21.51 $39.09 $66.71
Deduction
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