Dental Plan
Benefits Enrollment & Changes
You may enroll in benefits during your first 31 days of full-time employment. However, once elections have been submitted, you are unable to make changes even if you are still within your 31-day enrollment window. You may also make changes to current coverage within 31 days of the date you experience a qualified change in status or change coverage during the annual open enrollment period. Open Enrollment is typically held November 1 – 15 each year, and elections made during this period become effective January 1 of the next calendar year.
Dental Plan / Delta Dental of Missouri
No changes to coverage or rates for 2024.
Two dental plan options are offered through Delta Dental of Missouri. Both plans are traditional style dental plans with a deductible and coinsurance.
Under these plans, you may receive treatment from any dentist. There are two preferred networks of dentists that may be used with both plans – a PPO network and a Premier network. When you use these networks, you will be charged less for most services and will, therefore, incur a lower out-of-pocket expense. Non-network dentists may charge a rate that is over the maximum reasonable and customary charge allowed by Delta Dental. Delta Dental would deny that additional charge, and you would be responsible for paying that amount. Dentists participating in the PPO network generally agree to lower negotiated rates than dentists in the Premier network. However, both networks would protect you from being balance billed for any amounts the dentist would normally charge over the discounted rate they have negotiated with Delta Dental.
When you use PPO Network Dentists, the plan will pay 100% for your preventive care services. If you use Premier network dentists, or dentists who don’t participate in either Delta Dental network, the plan pays slightly less at 80%.
Both plans offer you preventive care, basic care (fillings, simple extractions, etc.), major care (crowns, implants), and orthodontia (for children or adults). The annual deductibles and annual benefit maximums do not apply to preventive dental services.
Additional Cleaning Benefit
Self-Report Form
Participants diagnosed with periodontal disease, pregnant women, diabetics, those with kidney failure or undergoing dialysis and those with suppressed immune symptoms are eligible for up to four periodontal and/or dental cleanings per calendar year. To be eligible for the additional cleaning benefit, you must submit a completed Self-Report Form.
Virtual Visits
Your Delta Dental coverage now includes Virtual Visits delivered by TeleDentistry.com, which provides 24/7 access to a dentist, 365 days a year. TeleDentistry is considered an oral examination under the plan. It’s a safe and effective way to receive care and avoid the emergency room when you have a dental emergency and do not have an established dentist, or when you need access to a dentist after hours or need to consult with a dentist without leaving your home.
Delta Dental Plans
Standard Dental Plan - This plan has higher deductibles and lower annual and lifetime benefit limits but a lower employee cost per pay period than the Buy-Up Plan.
Buy-Up Dental Plan - This plan has enhanced benefits for basic services and orthodontia as well as lower deductibles, but increased employee costs per pay period compared to the Standard Plan.
Plan Rates
|
Coverage Tier |
Standard Dental Plan Semi-Monthly Premium |
Buy-Up Dental Plan Semi-Monthly Premium |
|
2023 & 2024 |
2023 & 2024 |
|
|
Employee Only |
$3.93 |
$10.73 |
|
Employee + Spouse |
$11.78 |
$28.77 |
|
Employee + Child |
$9.41 |
$23.01 |
|
Employee + Family |
$15.10 |
$36.80 |
Plan Limits
|
Annual/Lifetime Limits |
Standard Plan |
Buy-Up Plan |
|
Deductible (per calendar year) Per Individual Maximum Per Family |
$100 $300 |
$50 $150 |
|
Maximum benefits paid by the plan (Per family member per calendar year) |
$1,000 |
$1,500 |
|
Orthodontia Lifetime Maximum (Per family member) |
$1,000 |
$2,000 |
Plan Benefits
|
Description of Service |
Standard Plan Pays |
Buy-Up Plan Pays |
|
Preventive Care Cleanings and X-rays |
100% (PPO network only) 80% (All other dentists) |
100% (PPO network only) 80% (All other dentists) |
|
Basic Care Fillings, Extractions, Root Canals |
60% |
80% |
|
Major Care Crowns, Bridgework, Dentures, Oral Surgery, Implants |
50% |
50% |
|
Orthodontia Children and Adults |
50% |
50% |