Provider: Delta Dental

Our dental provider is Delta Dental. They do not issue ID cards but you can print one when you create an online account at www.deltadentaloh.com. 

Eligibility

Benefit eligible employees and their spouses and/or same or opposite sex domestic partners (see definition of a domestic partner under Group Health Insurance) and their children are eligible.

Enrollment

Participation is optional and becomes effective on the date of employment if elected. Please contact the Office of Human Resources for enrollment information.

Cost Per Month 

Costs for the Dental Plan are available on our Fringe Benefits Cost Sheet, located on the benefits main page.

Preventive Services

Oral exams, teeth cleaning, x-rays, fluoride treatment for children, space maintainers, and topical sealants for children, etc.

Basic Services

Diagnostic services, restorative services, endodontics, certain periodontic services, oral surgery, certain prosthodontic services, general anesthesia, injectable antibiotics, etc.

Major Services

Restorative services, prosthodontic services, etc.

Orthodontia Services

Covers braces and appliances for children to the age of 19. There is a lifetime maximum of $1,000 per covered child.

Deductible

None for Preventive or Orthodontia. $50 per plan year (July 1 through June 30) for Basic and Major services, limited to only three deductibles per family.

Benefit Level Maximum

Maximum of $1,500 per covered person per year.

Dependent Children

Covered to the end of the month in which the child attains the age of 26.

Dental Plan Summary

HIPAA Privacy Notice