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DELTA DENTAL

DELTA DENTAL

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Delta Dental is State Industrial Products’ dental insurance provider. You may choose between two dental PPO plans – the Standard Plan and the Value Plan. If you have any questions regarding the dental plan or want to find a network provider, visit Delta Dental at deltadentaloh.com or call 1-800-524-0149.

Things to Consider about the Dental Plan

When you need dental care, you can go to any provider you choose. However, using network providers can save you money in two ways:

  • Participating network providers agree to accept Delta Dental’s fee based on their agreement with Delta Dental, which is typically lower than a provider that does not participate in a Delta Dental Network
  • Under the Standard PPO Dental Plan, you do not have to pay any amount above Delta Dental’s allowed fee when you receive care from a provider that participates in one of Delta Dental’s networks. If you see a dentist in the Premier network, you will pay the difference between the PPO allowed amount and the Premier allowed amount.
  • Both the Standard Plan and the Value Plan pay all claims at the PPO reimbursement level. So, with both the Standard and Value Plan, if you do not wany any balance billing, please choose a provider in the PPO network.

Standard Plan

Members receive the best value of care if they choose a PPO provider but can go to any dentist. Members will be responsible for any costs between the PPO fee and the Premier fee OR between the PPO fee and billed amount if a member goes to see an OON provider.

  Delta Dental PPO 
Dentist Plan Pays
Delta Dental Premier 
Dentist Plan Pays
Nonparticipating
Dentist Plan Pays
 Diagnostic & Preventative
Diagnostic and Preventative Services – exams, cleanings, fluoride, and space maintainers 100% 100% 100%
Emergency Palliative Treatment – to temporarily relive pain 100% 100% 100%
Sealants – to prevent decay of permanent teeth 100% 100% 100%
Brush Biopsy – to detect oral cancer 100% 100% 100%
Radiographs – X-rays 100% 100% 100%
Periodontal Maintenance – cleanings following periodontal therapy 100% 100% 100%
Basic Services
Minor Restorative Services – Fillings and crown repair 80% 70% 70%
Endodontic Services – root canals 80% 70% 70%
Periodontic Services – to treat gum disease 80% 70% 70%
Oral Surgery Services – extractions and dental surgery 80% 70% 70%
Other Basic Services – misc. services 80% 70% 70%
Relines and Repairs – to prosthetic appliances 80% 70% 70%
Major Services
Major Restorative Services – crowns 60% 40% 40%
Prosthodontic Services – bridges, implants, dentures, and crowns over implants 60% 40% 40%
Orthodontic Services
Orthodontic Services – braces 50% 40% 40%
Orthodontic Age Limit  through age 18 and under through age 18 and under through age 18 and under

 

Dental Monthly Contributions

Employee Only Employee + 1 Dependent Employee + Two or More Dependents
$42.00 $84.00 $126.00

Value Plan

The Value Plan offers coverage for Preventive and Basic Services only and members must see a PPO provider if they want any dental coverage under this plan.

Annual Deductible: $50/$150
Annual Benefit Maximum: $1,000
Delta Dental PPO 
Dentist Plan Pays
Delta Dental Premier 
Dentist Plan Pays
Nonparticipating
Dentist Plan Pays
 Diagnostic & Preventative
Diagnostic and Preventative Services – exams, cleanings, fluoride, and space maintainers 100% 0% 0%
Emergency Palliative Treatment – to temporarily relive pain 100% 0% 0%
Sealants – to prevent decay of permanent teeth 100% 0% 0%
Brush Biopsy – to detect oral cancer 100% 0% 0%
Radiographs – X-rays 100% 0% 0%
Periodontal Maintenance – cleanings following periodontal therapy 100% 0% 0%
Basic Services
Minor Restorative Services – Fillings and crown repair 80% 0% 0%
Endodontic Services – root canals 80% 0% 0%
Periodontic Services – to treat gum disease 80% 0% 0%
Oral Surgery Services – extractions and dental surgery 80% 0% 0%
Other Basic Services – misc. services 80% 0% 0%
Relines and Repairs – to prosthetic appliances 80% 0% 0%

Dental Monthly Contributions

Employee Only Employee + 1 Dependent Employee + Two or More Dependents
$25.00 $50.00 $75.00

Finding a Dentist

You already have great dental benefits – do you have a great dentist, too? Having a dentist and dental office that you trust and can easily share concerns with make it more likely you’ll stay on top of those regular dental cleanings. Ask friends or family for recommendations, or use Delta Dental’s Find a Dentist tool at www.deltadentaloh.com/findadentist to look for options in your area.

Need to Get in Touch?

Customer service is available 8:30 am to 8 pm Monday – Friday EST at 800-524-0149

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