Two coverage options are available, the Dental Base Plan and the Dental Buy Up Plan. Both options cover three classes of reasonable and customary expenses: preventive, basic and major services, and the Buy Up Plan expands coverage to include orthodontics (up to $1,500 maximum lifetime benefit), lower deductible and higher annual maximum.
The dental plan utilizes a passive network, which means you have the ability to receive services from network or non-network providers. No matter your provider, your deductible and coinsurance remain the same as long as charges are reasonable and customary.
Jump to: 2023 Dental Plans | 2022 Dental Plan
2023 Dental Plans
Costs
For a printable version, download the Plan Information and Comparison handout (375KB, PDF), which features a comparison chart and premium rates for the available insurance plans.
Click on a header to expand the selection and uncover additional information.
? Premiums
Monthly employee premium cost for active employees:
Dental Base Plan
- Self only: $15.53
- Self and spouse: $31.05
- Self and child(ren): $37.68
- Self, spouse and child(ren): $53.21
Dental Buy Up Plan
- Self only: $22.46
- Self and spouse: $44.89
- Self and child(ren): $72.13
- Self, spouse and child(ren): $96.44
* Premiums for retirees vary according to a formula based on years of service and other factors. For more information about retiree insurance eligibility and premiums, visit the Retiree benefits overview webpage.
? Covered Services
Both the Base Plan and the Buy Up plan offer coverage for three classes of reasonable and customary expenses: preventive, basic and major services. Reimbursements are limited to fees determined to be reasonable and customary.
- Preventive services- Preventive care for routine oral exams, cleaning, x-rays, sealants and flouride:
- 100% (no deductible)
- Basic services- Basic care for treatments such as fillings, oral surgery and extractions:
- 80% after annual deductible
- Major services- Major treatment such as bridgework, dentures and crowns:
- 50% after annual deductible
For the Dental Buy Up Plan only, orthodontics are also covered:
- Orthodontia services- Treatments such as those for alignment and occlusion of the teeth and jaws:
- 50% (no deductible) up to lifetime maximum
➖ Deductible
Base Plan
- Self: $100
- Family: $300
Buy Up Plan
- Self: $50
- Family: $150
? Maximum Benefit
Dental Base Plan
Base Plan coverage has a maximum annual benefit of $1,500 for each individual enrolled in the plan. This cap is for preventive, basic and major care combined.
Dental Buy Up Plan
The Dental Buy Up Plan has a maximum annual benefit of $2,000 for each individual enrolled in the plan. This cap is for preventive, basic and major care combined. Additionally, this plan has an orthodontia lifetime maximum of $1,500 for each covered individual, including eligible adults and children.
Making the Most of Your Plan
Click on a header to expand the selection and uncover additional information.
? Network Providers
The University dental plans utilize a passive network, which means you have the ability to receive services from network or non-network providers. No matter your provider, your deductible and coinsurance remain the same as long as charges are reasonable and customary. However, using either of Delta Dental’s two networks, PPO or Premier, may help you achieve more affordable services. The Delta Dental PPO Network offers the lowest negotiated services, often resulting in the greatest savings.
Provider directories may be accessed on the plan contacts webpage.
? Discounts
Visit the health and wellness tools and discounts webpage to maximize your convenience and savings.
- Base Plan Overview flyer
- Buy Up Plan Overview flyer
- Delta Dental Network Advantage flyer
- Delta Orthodontics In-Progress flyer
- Delta New Orthodontics Treatment flyer
- Delta Orthodontics Q&A
- View all available Summary Plan Descriptions (SPDs)
- 2023 Benefits Enrollment Form For active faculty and staff who are newly eligible for benefits (e.g., newly hired or newly promoted to a benefit-eligible job)
- 2023 Benefits Change Form For active faculty and staff who have a family status change.
- Delta Dental mobile app
2022 Dental Plan
Costs
For a printable version, download the Plan Information and Comparison handout (375KB, PDF), which features a comparison chart and premium rates for the available insurance plans.
Click on a header to expand the selection and uncover additional information.
? Premiums
Monthly employee premium cost for active employees:
- Self only: $14.76
- Self and spouse: $29.52
- Self and child(ren): $35.82
- Self, spouse and child(ren): $50.58
* Premiums for retirees vary according to a formula based on years of service and other factors. For more information about retiree insurance eligibility and premiums, visit the Retiree benefits overview webpage.
? Covered Services
Coverage is offered for three classes of reasonable and customary expenses: preventive, basic and major services.
- Class A services- Preventive care for routine oral exams, cleaning, x-rays, sealants and flouride:
- 100% (no deductible)
- Class B services- Basic care for treatments such as fillings, oral surgery and extractions:
- 80% after annual deductible
- Class C services- Major treatment such as bridgework, dentures and crowns:
- 50% after annual deductible
➖ Deductible
- Self: $100
- Family: $300
? Maximum Benefit
Dental coverage has a maximum annual benefit of $1,500 for each individual enrolled in the plan. This cap is for preventive, basic and major care combined.
Making the Most of Your Plan
Click on a header to expand the selection and uncover additional information.
? Network Providers
The University dental plan utilizes a passive network, which means you have the ability to receive services from network or non-network providers. No matter your provider, your deductible and coinsurance remain the same as long as charges are reasonable and customary. However, using either of Delta Dental’s two networks, PPO or Premier, may help you achieve more affordable services. The Delta Dental PPO Network offers the lowest negotiated services, often resulting in the greatest savings.
Provider directories may be accessed on the plan contacts webpage.
? Discounts
Visit the health and wellness tools and discounts webpage to maximize your convenience and savings.
- View all available Summary Plan Descriptions (SPDs)
- 2022 Benefits Enrollment Form For active faculty and staff who are newly eligible for benefits (e.g., newly hired or newly promoted to a benefit-eligible job)
- 2022 Benefits Change Form For active faculty and staff who have a family status change.
- Delta Dental mobile app
* In the event of a difference between this webpage and the plan document or summary plan description, the plan document and plan description prevail.
Reviewed 2022-09-26
