Dental

Dental Plan

Maintaining good dental health by getting regular checkups may prevent you from having major expenses later. The plan covers routine checkups and comprehensive coverage for other types of dental work you might need. Our plan also offers you the flexibility to seek treatment from any provider. As with our Health Plan, you will maximize your dental benefits if you use a Delta Dental provider due to the agreements Delta has in place with their contracted dentists. Should you decide to use a non-participating dentist, please be advised that your provider may balance bill you for any amount over the Delta Dental Maximum Plan Allowance.

Even though you are not required to use a Delta Dental provider, you have access to the largest dental network in the state of Kansas. To learn more about the Delta Dental network, if your dentist participates in the network, or for more information regarding our dental plan provider, please visit their website at: www.deltadentalks.com. Please click on the “Dentist Search” link located halfway down the home page under the section titled “Searching for a Dentist.” In the “Dentist Search” section, you may choose either the “Delta Dental Premier” or “Delta Dental PPO” providers. You can search for providers by name, city and state, or zip code. Inquiries may also be made by calling Customer Service at: (800) 234-3375. (This number can also be found on your identification card).

Below is a brief summary of the dental plans available to you and your family. Please refer to the Delta Dental benefit summaries for more detailed information.

Services

ServicesDescriptionBenefit Amount
Type I ProceduresExams, cleanings, fluoride
treatments (2 per year)
Plan pays 100% of the Maximum Plan Allowance, This
benefit does not apply towards the Annual Maximum
Type II ProceduresRegular fillings (amalgam or
composite), extractions, nonsurgical
root canals
Maximum After deductible is met, the plan pays 80% of the
Plan Allowance
Type III ProceduresInlays, crowns, dentures,
implants
After deductible is met, the plan pays 60% of the Maximum Plan Allowance
Type IV ProceduresOrthodontia services
For adults and children
After deductible is met, the plan pays 50% of the
Maximum Plan Allowance up to a Lifetime Maximum
Benefit of $2,500
Annual DeductibleApplies to Type II, III, and IV
Procedures
$25 per person
Annual MaximumPer covered person$2,500

Employee Cost per Pay Period

Employee Cost per Pay PeriodEmployee ShareEmployer Share
Employee $8.16$12.23
Employee + Spouse$23.29$34.95
Employee + Child(ren)$20.09$30.14
Family$25.69$38.53

Downloads

Summary of Benefits

Delta Dental Contract