Page 14 - 2016 Enrollment
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Find an In-Network Dental Coverage
Provider
1. Visit www.deltaldentalWA.com Dental coverage is offered through Delta Dental. Our dental plan makes
dental care more affordable for employees and their families. Remember
2. Click on the Dentist tab from the to choose an in-network dentist to ensure you’re receiving the deepest
homepage
level of discounted services.
3. Click on “Find a Dentist” on the
right-hand side of the page With this coverage you’ll have broad access to preferred provider
4. Click the “Delta Dental PPO organizations (PPO) and Premier providers. With an expansive selection
Network” of network providers you have a better chance of avoiding additional
out-of-pocket exposure or “balance billing”. Balance billing is the practice
5. Complete your additional search
criteria information of non-network providers billing the patient for amounts which exceed
Select a provider in-network to receive the reimbursement amount under a patient’s dental plan. The patient is
the deepest level of discount on your responsible for the additional amounts charged, therefore it is important
services. to use a PPO or Premier provider to avoid excessive out-of-pocket
exposure.
Dental Coverage Level
PPO Premier Out-of-Network
Calendar Year Deductible
Individual $0 $50 $50
Family $0 $150 $150
Calendar Year Maximum
Individual beneit $2,000 per person
Dental Services
Preventive 100% 100% 100%
Basic 80% 80% 80%
Major 50% 50% 50%
Orthodontia
Coinsurance 50%
Lifetime maximum $1,500
Orthodontia services are available for adults and dependent children to
age 26.
Monthly Dental Contributions
Employee $13.93
Employee + spouse $29.26
Employee + child(ren) $25.08
Family $44.58
Shape Technologies Group
Find an In-Network Dental Coverage
Provider
1. Visit www.deltaldentalWA.com Dental coverage is offered through Delta Dental. Our dental plan makes
dental care more affordable for employees and their families. Remember
2. Click on the Dentist tab from the to choose an in-network dentist to ensure you’re receiving the deepest
homepage
level of discounted services.
3. Click on “Find a Dentist” on the
right-hand side of the page With this coverage you’ll have broad access to preferred provider
4. Click the “Delta Dental PPO organizations (PPO) and Premier providers. With an expansive selection
Network” of network providers you have a better chance of avoiding additional
out-of-pocket exposure or “balance billing”. Balance billing is the practice
5. Complete your additional search
criteria information of non-network providers billing the patient for amounts which exceed
Select a provider in-network to receive the reimbursement amount under a patient’s dental plan. The patient is
the deepest level of discount on your responsible for the additional amounts charged, therefore it is important
services. to use a PPO or Premier provider to avoid excessive out-of-pocket
exposure.
Dental Coverage Level
PPO Premier Out-of-Network
Calendar Year Deductible
Individual $0 $50 $50
Family $0 $150 $150
Calendar Year Maximum
Individual beneit $2,000 per person
Dental Services
Preventive 100% 100% 100%
Basic 80% 80% 80%
Major 50% 50% 50%
Orthodontia
Coinsurance 50%
Lifetime maximum $1,500
Orthodontia services are available for adults and dependent children to
age 26.
Monthly Dental Contributions
Employee $13.93
Employee + spouse $29.26
Employee + child(ren) $25.08
Family $44.58
Shape Technologies Group
