Page 11 - California Steel EE Guide 01-2020
P. 11

BENEFITS





         Dental Insurance


         Delta Dental | PPO Dental Plan
         With the Preferred Provider Organization (PPO) dental plan, you may visit a PPO dentist and benefit from the negotiated rate  or
         visit a non‐network dentist. When you utilize a network dentist, your out-of-pocket expenses will be less. You may also obtain
         services using a non-network dentist; however, you will be responsible for the difference between the covered amount and the
         actual charges and you may be responsible for filing claims.

                                                                                    Delta Dental
         Plan Name                                                                      PPO
         Network Name                                                 Delta Dental PPO            Non-Network
         Dental Benefits

         Calendar Year Maximum                                                         $2,000
         Calendar Year Deductible
          - Individual                                                      $0                        $50
          - Family                                                          $0                  $50 per Member
         Diagnostic & Preventive Services                                No Charge                No Charge*
         Exams, X-Rays, Cleanings
         Basic Services                                                     20%                 Deductible, 20%*
         Fillings, Posterior Composites and Sealants, Endodontics (Root
         Canals), Periodontics (Gum Treatment), Oral Surgery
         Major Services                                                     50%                 Deductible, 50%*
         Crowns, Inlays, Onlays and Cast Restorations, Prosthodontics
         (Bridges, Dentures, Implants)
         Orthodontia (Children & Adults)                            Included in the $2,000/person Calendar Year Maximum
                                                                                         50%                                      Deductible, 50%*

         *Reimbursement is based on Delta Dental maximum contract allowances and not necessarily each dentist’s submitted fees.


                        Finding a Dental Provider
                        Go to www.deltadentalins.com or call (800) 765-6003. Refer to the “PPO” network when prompted.




         Tips for Using Your Dental Benefits

             Understand your plan.
         
             Understanding your dental plan’s benefits, including how copays, deductibles, and calendar year maximum benefits work, is
             key to getting the most value from your plan and avoiding surprises.

             Take advantage of preventive services offered by the plan.
         
             The least expensive way to maintain good oral health is to go to your dentist twice each year for an exam and cleaning.
             Regular dentist visits can help prevent serious health problems such as oral diseases and cancers, and going to the dentist is
             more affordable in the long run for those who are insured and take advantage of every service.

         
             Ask for a predetermination of benefits.
             We recommend you ask your dentist for a predetermination if total charges are expected to exceed $300. Predetermination
             enables you and your dentist to know in advance what the payment will be for any service that may be in question.
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