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DENTAL PLANS
Your dental plan options provide coverage for routine exams and cleanings and pay for a portion of other services, as shown in the chart below.
It’s important to have regular dental exams and cleanings so problems are detected before they become painful—and expensive. Keeping your teeth and gums clean and healthy will help prevent most tooth decay and periodontal disease, and is an important part of maintaining your medical health.
You have a choice of two dental plans: the Core Plan and the Buy-Up Plan.
Dental benefits are administered by Delta Dental.
PLAN PROVISION
CORE PLAN
BUY-UP PLAN
Annual Deductible – Individual/Family
$50 / $150
$50 / $150
Annual Maximum per person
$1,500
$2,000
Diagnostic and Preventive Services, to include oral exams, cleanings, x-rays, fluoride treatments, sealants, and space maintainers
100%, no deductible
100%, no deductible
Basic Services to include fillings, oral surgery, simple extractions, and endodontics
80%*
80%*
Major Services to include crowns, periodontics, inlays and onlays, complete dentures, and fixed partial dentures
50%*
50%*
Orthodontia (Child only up to age 19)
Not Included
$1,500 Lifetime Maximum
*After deductible is met.
Note: This is a summary only of your coverage. Please refer to your summary plan description for the full scope of services. In-network services are based on negotiated charges; out-of-network services are based on reasonable and customary (R&C) charges.
Employee + Child
Employee + Child(ren)
Employee + Family
Split Family
$3.58
$4.76
$13.60
$7.91
CORE PLAN
$7.15
$9.52
$27.20
$15.81
$17.17
BUY-UP PLAN
2019 PRE-TAX DEDUCTIONS
PER CHECK
MONTHLY
PER CHECK
MONTHLY
Employee Only
Employee + Spouse
$0
$6.55
$0
$13.10
$5.13
$10.25
$34.33
$12.87
$14.44
$25.74
$28.88
$31.52
$63.04
$26.35
$52.70
*If you enroll in the buy-up plan option, you must remain in the buy-up plan for 2 years.
Note: You may not cover family members under your dental plan if they have elected dental as a City of Raleigh employee. Dual coverage is not permitted.
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