Dental Plans
2024 Coverage
|
COVERAGE |
High Plan | Low Plan | ||
| PPO Network | Premier/
Out-of-Network |
PPO Network | Premier/
Out-of-Network |
|
Annual Deductible
|
None |
$50 $150 |
$50 $150 |
$100 $300 |
| Preventive and Diagnostic Treatment | 100% | 100% | 100% | 100% |
| Basic Treatment | 90% | 80% | 80% | 70% |
| Major Treatment | 60% | 50% | 50% | 40% |
|
Orthodontia Treatment |
50% |
50% |
No coverage |
No coverage |
| Annual Maximum Benefit | $2,250 | $2,250 | $1,250 | $1,250 |
| Orthodontia Life Time Maximum | $1,500 | $1,500 | ||
– Preventive/Diagnostic services are exempt from deductible & annual maximum benefit
– Orthodontia coverage provided for adults & dependents through age 26
2024 Costs
| Bi-weekly Rates | High Plan | Low Plan |
| Employee | $20.53 | $15.68 |
| Employee +1 | $41.25 | $30.42 |
| Family | $72.87 | $45.74 |
Everyone deserves a healthy smile. Keep your family smiling with affordable Dental coverage provided by Delta Dental.
Eligibility Information
As a full-time employee, 30+ hours per week, you, your spouse, and dependent children up to age 26 are eligible for Medical, Dental, and Vision insurance benefits. Coverage begins the first day of the month following your date of hire.
Employees must enroll in benefits before the end of their 30th calendar day of employment, otherwise they are not eligible and will have to wait until annual Open Enrollment. Enroll through your Workday account.
Changes During the Year
Generally, you can only change your benefit elections during the annual benefits Open Enrollment period. An exception is made for any Qualified Life Event (QLE), such as marriage, divorce, birth, or adoption.
You must notify Human Resources within 30 days of any QLE to make changes. Otherwise, you will have to wait until the next enrollment period. Any changes you make to your benefit choices must be directly related to the Life Event. You must enclose documentation of the event and the documentation must show the date of the event (example: a marriage license or birth certificate). Do this through your Workday account.
When Coverage Ends
Dental benefits end at the last day of the month following your last day worked. However, you may be able to purchase continued medical and dental, on an individual basis, for a period of time under a federal law known as the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA).
Find a Dentist, Contact and Plan Information
Access Delta Dental of Virginia to find dentists, manage your dental benefits and access resources.
| Delta Dental |
(800) 237-6060 |
www.deltadentalva.com |
