Dental Benefit Plan

Insurance Company Delta Dental of Iowa
Annual Maximum Benefit $1,200 per participant per calendar year
Deductible Participant Pays
$50 per participant per calendar year

Preventive Benefits
(Routine Exams, Cleanings, X-Rays)

Deductible Waived
$0

Basic Benefits
(Periodontics, Root Canals, Extractions, Fillings)

Deductible, then 20%

Major Benefits
(Caps, Crowns, Dentures, Bridges)

Deductible, then 50%

Providers

Participants have access to Delta's Premier Network Providers - although they may obtain services from non-network providers.
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August 30, 2016
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