Dental Plan Options
Your dental plan is a Preferred Provider Plan administered by Delta Dental of Kansas.
You can choose between two plans:
- Basic Plan
Provides benefits for diagnostic, preventive and basic care eligible charges (including exams, cleanings, fillings and X-rays).
- Comprehensive Plan
Provides all of the above, plus offers coverage for a more extensive range of dental care including orthodontia.
Full-Time Monthly Dental Plans Rates (Employees Working 32+ Hours) |
||
Coverage Tiers |
Basic Plan | Comprehensive Plan |
Employee Only |
$5 | $19 |
Employee + Spouse/Domestic Partner |
$15 | $41 |
Employee + Child(ren) |
$18 | $48 |
Family |
$27 | $70 |
Dental Plan Options Summary |
|
Basic Plan |
|
Deductible Per Person |
$50/$150 Per Family |
Preventive/Diagnostic |
100% (Not Subject to Deductible) |
Basic Services |
80% (After Deductible) |
Major Services |
Not Covered |
Annual Benefit Maximum |
$750 Per Person |
Comprehensive Plan |
|
Deductible Per Person |
$100/$300 Per Family |
Preventive/Diagnostic |
100% (Not Subject to Deductible) |
Basic Services |
80% (After Deductible) |
Major Services |
50% (After Deductible) |
Annual Benefit Maximum |
$1,500 Per Person |
Orthodontia |
50% (After Deductible) |
Orthodontia Lifetime Maximum |
$2,000 Per Person |
Preventive Services
- Routine dental examinations: Twice per calendar year
- Cleaning: Twice per calendar year
- Topical fluoride application for children under age 19: Twice per calendar year
- Total mouth x-ray: Once every 36 months
- Bitewing x-rays: Twice per calendar year
Basic Services
- Restorations (fillings): Amalgam, silicate cement, acrylic and composite
- Stainless steel crowns for children under the age of 13
- Oral Surgery: Extractions (uncomplicated surgical removal of an erupted tooth), incision/drainage of abscess, cyst or tumor removal
- General anesthesia and postoperative care
- Periodontics: Root planning/scaling, gingivectomy/gingivoplasty
- Endodontics: Root canals (including necessary x-rays/cultures, excluding final restoration), denture or bridge work repairs
Major Services
- Inlays and crowns
- Artificial teeth
- Removable bridge
- Dentures