8/14/2019 Microsoft Word - Delta Dental General Marketing

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Delta Dental Benefits

DeltaPPO Option (PPO) is a discounted fee-for-service, managed-cost dental plan thatallows you the freedom to choose any dentistfor treatment, (but you will receive thegreatest benefit from a dentist participating inDeltas preferred provider network.) The DeltaPremier program has the nation's largestdental network, with more than three out ofevery four of the country's dentistsparticipating. DeltaPremier provides a level of

enrollee protection that is unmatched.

DeltaCare USA Option (HMO) Delta Care USAis Delta Dentals national Dental HealthMaintenance Organization. Subscribers selectfrom a panel of primary care dentists. Thesedentists manage subscribers comprehensivedental needs including referrals to specialists,which earns each dentist a monthly capitationamount. Delta Care USA is the choice forgroups seeking lower costs, an emphasis onprevention and access to a pre-selectednetwork of dentists.

Eligibility. Staff of current NYCON memberswho work at least 20 hours per week areeligible to enroll effective the first of any monthafter the signing of a group contract with theNew York Council of Nonprofits, Inc. NYCONwill provide identification cards for this plan.Subscribers may also use their social securitynumber and the group number indicated asproof of their enrollment and benefits.

If an eligible member does not enroll eligible dependents

in the plan at the time of enrollment, they will need to wait until

the next open enrollment date to add them unless there is a

qualifying event. There will be an open enrollment period in

Contact Eric Laughlin, Marketing Associate1(800) 515-5012 ext. 128

Email: elaughlin@councilservicesplus.com

Fine Print

Complete

definition of

benefits,

limitations &

exclusions is

contained in th

Group Dental

Service Contrac

This explanatio

informational o

Benefits subjec

all terms &

conditions of th

Group Dental

Service Contrac

For more

informatio

Please contact

Laughlin at (80515-5012 ext.

or visit

www.ccsnys.or

Two Plans. Your Choice.

Delta PPODental Services Paid by Delta

Diagnostic 90%Preventive 90%Oral Surgery 80%Endodontic 70%Orthodontics 50%TMJ 50%

Periodontal 50%Major Restorative 50%

Maximums: $2000 per person per calendar year.

Orthodontics has a separate maximum of $1250 lifetime

per patient. Deductible: $50 per person per calendar year.

Maximum of $150 per family per calendar year. Does not

apply to Diagnostic and Preventative care.

Dependent children are covered to age 19. Full-timedependent students enrolled in bona fide institution ofhigher education are covered to age 23. Mentally andphysically disabled dependent children are eligible fordental care under the program regardless of age.Orthodontics is only a benefit for dependent children to age19.

Coverage is available for qualified Domestic Partners.Call for more info on enrolling Domestic Partners. Pleasenote: There is a 60-day waiting period for all new hires.

2009 Monthly Payments

Individual $31.36

2-Person $81.22

Family $104.40

Delta Care USA

Dental Services Paid by Delta

Periodic oral evaluation No costDiagnostic Casts No cost

Cleaning (1 every 6 months) No cost

Replacement Crown $10

Crown (Resin, Indirect) $110

Root Canal (Molar) $180

The services above represent a sample of frequently used

services. For full details please contact NYCON.

No Deductible. Maximums: Please see contract pricing

sheet for details. Maximums may apply to specific areas.

Dependent children are covered to age 19. Full-timedependent students enrolled in bona fide institution of

higher education are covered to age 23. Mentally andphysically disabled dependent children are eligible fordental care under the program regardless of age.Orthodontics is only a benefit for dependent children to age19.

Coverage is available for qualified Domestic Partners.Call for more info on enrolling Domestic Partners.

2009 Monthly PaymentsIndividual $30.602-Person $46.34Family $63.73