Delta Dental
BENEFITS AT A GLANCE
Benefits and Covered Services
- Diagnostic & Preventive
- Services (D & P)
- Exams, cleanings and x-rays
- Basic Services
- Fillings, posterior composites,
- simple tooth extractions, sealants and denture repair
- Endodontics (root canals)
- Periodontics (gum treatment)
- Oral Surgery
- General anesthesia
- Major Services
- Crowns, inlays, onlays and cast restorations
- Implants
- Bridges and dentures
- No waiting period
- Orthodontic Benefits
- Adults and dependent children
- No waiting period
- MPD – TMJ Benefits
The plan pays 100% of the first $400.00 of expenses, then 50% of the next $1,600.00 of expenses.
Annual maximum is $1,200 per person each calendar year
Delta Dental PPO Plan Summary flyer
Save with PPO
Visit a dentist in the PPO network to maximize your savings. These dentists have agreed to reduced fees, and you won’t get charged more than your expected share of the bill. Find a PPO dentist at deltadentalins.com.
Set up an online account
Get information about your plan anytime, anywhere by signing up for an online account at deltadentalins.com. This useful service, available once your coverage kicks in, lets you check benefits and eligibility information, find a network dentist and more.
Check in without an ID card
You don’t need a Delta Dental ID card when you visit the dentist. Just provide your name, birth date and enrollee ID or Social Security number. If your family members are covered under your plan, they will need your information. Prefer to take a paper or electronic ID card with you? Simply log in to your account, where you can view or print your card with the click of a button.
Plan Documentation
| Calhoun City Schools provides dental insurance for all eligible employees and pays for the Employee Only amount on all tiers of coverage. |
2023 MONTHLY PREMIUM
| Coverage Tier | Employee Cost | Employer Pays | Total Cost |
| Employee Only | $0.00 | $29.14 | $ 29.14 |
| Employee + Spouse | $32.40 | $ 29.14 | $61.54 |
| Employee + Child(ren) | $48.62 | $ 29.14 | $77.76 |
| Family | $70.64 | $ 29.14 | $99.78 |
If both parents are employees, only one parent can cover children to age 26 and employees cannot be covered as both an employee and a dependent.
Eligibility – All full-time employees working 75% (or 100% in the case of bus drivers) of assigned full-time position per week are eligible for coverage the first of the month following one calendar month of continuous employment. Legally married spouses and eligible dependent children to age 26.
USEFUL INFORMATION FROM DELTA
Claims
Claims Address
P.O. Box 1809
Alpharetta, GA 30023-1809
Customer Service- 800-521-2651
