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Delta Dental PPO

All Faculty and Staff

This Delta Dental network plan allows you to go to any Dentist of your choice and receive a level of benefits for covered services, but you will receive the best value from your plan if you visit a network Dentist.

Delta Dental PPO Dentists are part of a more limited network of Participating Dentists who offer lower fees to their Delta Dental PPO patients.

Delta Dental PPO Dentists are reimbursed by Delta Dental based on the lesser of the submitted charge or Delta Dental’s allowance for PPO Dentists in the geographic area in which the services were provided.

PPO Dentists agree to accept Delta Dental’s payment as payment in full, and further agree not to charge any difference between their fees and the amount paid by Delta Dental back to their Delta Dental patients.

You may also choose to visit Dentists who are not Delta Dental Participating Dentists (Nonparticipating Dentists) or Other Dental Providers (ODPs).

Delta Dental PPO Dentists are part of a more limited network of Participating Dentists who offer lower fees to their Delta Dental PPO patients.

Delta Dental PPO Dentist are reimbursed by Delta Dental based on the lesser of the submitted charge or Delta Dental's allowance for PPO Dentists.

 

Outline of Coverage - Delta Dental PPO Plus Premier Network

Click on image to see larger version

 

Dental Coverage Plan Summary

Calendar Year Deductible

 

Delta Dental PPO Plus Premier Network

Non-Participating Dentist

Individual

$50.00

$50.00

Family

$150.00

$150.00

Calendar Year Maximum Benefit

 

$1,000

$1,000

Preventive Care (Cleanings, Oral Examinations, Fluoride Treatments, etc.)

 

100%

 

100%

Basic Care (Filings, Simple Extractions, Root Canal, etc.)

 

60%

 

60%

Major Care (Crowns, Onlays, Bridges, etc.)

 

50%

 

50%

Orthodontia

Coverage

Children to age 19

 

Benefit

50%

50%

Lifetime Maximum

$1,500

$1,500

See Separate rate sheets for employee contribution rates.

 

 

Dental Coverage Buy-up Plan Summary

Calendar Year Deductible

 

Delta Dental PPO Plus Premier Network

Non-Participating Dentist

Individual

$50.00

$50.00

Family

$150.00

$150.00

Calendar Year Maximum Benefit

 

$2,000

$2,000

Preventive Care (Cleanings, Oral Examinations, Fluoride Treatments, etc)

 

100%

 

100%

Basic Care (Filings, Simple Extractions, Root Canal, etc.)

 

60%

 

60%

Major Care (Crowns, Onlays, Bridges, etc.)

 

50%

 

50%

Orthodontia

Coverage

Children to age 19

 

Benefit

50%

50%

Lifetime Maximum

$1,500

$1,500

See Separate rate sheets for employee contribution rates.

 

 

Rates:

 

NH Staff/CGPS (12 mos)        NH Staff (10 mos)    AZ Faculty/Staff    RFF (12mos/8mos)

 

Other Helpful Tools:

 

Find a dentist.

Click here to view your ID card and find a dentist using our mobile app.

 

Detailed Plan Documents:

Summary Plan Description

Outline of Coverage

Visit the Northeast Delta Dental Site for additional information:

(603)223-1000

www.nedelta.com

©2018 Franklin Pierce University
40 University Drive
Rindge, New Hampshire 03461