Call (877) 759-5762 to speak to a licensed agent!
Great coverage from day one, with no waiting periods except orthodontia.
Plan Highlights
- Free Choice of Dentist
- Ortho Benefits Included
- $100 Deductible
- $3,000 Calendar Year Max
| Service Class | Wait | Plan Pays | ||
|---|---|---|---|---|
| Year 1 | Year 2 | Year 3 | ||
| Diagnostic & Preventive (Exams, Cleaning & X-Rays) | None | 80% | 90% | 100% |
| Basic (Fillings) | None | 60% | 70% | 80% |
| Major (Crowns, Bridges, Endodontics & Periodontics) | None | 50% | 50% | 50% |
| Orthodontia (Available for eligible dependent children up to the age of 26) | 12 Months | 0 | 50% | 50% |
| Deductible (Per Person, Per Calendar Year) | $100 | |||
| Orthodontia Deductible (Lifetime Per Dependent) | $150 | |||
| Plan Maximum (Per Person, Per Calendar Year) | $3,000 | |||
| Orthodontia Maximum (Lifetime Per Dependent. Limited to $500 Per Calendar Year.) | $1,500 | |||
- There is a one-time, non-refundable, $35 set up fee charged with the first month’s premium.
- Reimbursement is based on Delta Dental PPOSM Contracted Fees for Delta Dental PPO Providers, Premier Contracted Fees for Delta Dental Premier® Providers and Program Allowance for Non-Delta Dental Dentists.
- For Benefits Association, Inc. members including Individuals, Small Employers (fewer than 5 employees) & Senior Citizens
We'll be happy to answer any questions you might have. Send us an email using the information request link below or call us at (877) 759-5762.
Information Request