EMMC offers three dental options that are administered by Northeast Delta Dental. Below is a chart of the dental plan options.
The following benefits are available to benefits-eligible employees. (See the General Benefit Information link for an explanation of benefits- eligible and non benefits-eligible statuses).
|
DENTAL OPTIONS |
|
|
Basic |
Core |
Plus |
|
Annual Maximum Benefit Per Person |
$1,000 |
$1,000 |
$1,500 |
|
Annual Deductible |
$25 individual
$75 family |
$25 individual
$75 family |
$50 individual
$150 family |
|
Preventative / Diagnostic:
- Cleanings either regular or periodontal, twice per calendar year
- Fluoride once in a 12 month period to age 19
- Sealant, application to permanent molars, once in a lifetime per tooth to age 15
- Evaluations twice per year
- X-Rays (complete series or panoramic) once in a 3 year period
- X-Rays (bitewing) once in a 12 month period
|
100% (not subject to deductible) |
100% (not subject to deductible) |
100% (not subject to deductible) |
|
Basic Restorative:
- Restorative: Amalgam fillings & composite white fillings
- Oral Surgery: Surgical & routine extractions
- Endodantics: Root Canal Therapy
- Periodontics: Treatment of gum disease
- Denture Repair: Repair of removable denture to its original condition
- Emergency Palliative Treatment
|
60% after deductible |
60% after deductible |
80% after deductible |
|
Major Restorative:
- Prosthodontics: Removable and fixed partial dentures (bridges); complete dentures
- Rebase & reline (dentures)
- Crowns
- Onlays
- Implants (PLUS PLAN ONLY)
|
Not covered |
50% after deductible |
50% after deductible
|
|
Orthodontia:
- Correction to Malposed (crooked) teeth for adults and dependent children
- Orthodontia has a maximum lifetime benefit of $1500 per person per
|
Not Covered |
Not Covered |
50% after unique $100 per person deductible
($1,500 lifetime maximum per person) |
Note: Dental options cannot be changed during the year, for any reason, even if an employee experiences a qualified status change. Dental options can only be changed during Annual Open Enrollment.
** The benefits and plans described on this site are for illustration purposes only and are subject to the appropriate Summary Plan Description (SPD), which may change in its entirety at any time. All SPDs are contained in the HR -Benefits Office. |
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