Tri-County Schools Insurance Group (Group No. 7084) offers two very distinct dental programs through Delta Dental of California.
The first is the long standing, popular plan referred to as the Delta Premier Plan. Under this program, Delta pays 70 percent of the approved fees for covered diagnostic, preventive, basic, cast and crown benefits during the first year you are eligible. This percentage will increase 10 percent each year (to a maximum of 100 percent) for each enrollee, provided that person visits the dentist at least once during the year. If any enrollee does not use the program during a calendar year, the percentage remains at the level reached the previous year. If an enrollee becomes ineligible for benefits and later regains eligibility, the percentage will drop back to 70 percent.
In addition, effective July 1, 2006, an enhancement of $250 was added to the Delta Dental Premier program when you use the service of a Delta DPO/PPO dentist. For example, if you have an annual maximum of $2,000 you have an additional $250 to use above your annual maximum if you use a Delta DPO/PPO dentist for the additional $250 of work.
The second option is referred to as the Delta Preferred Option (DPO). Under this program, Delta pays 100 percent of the approved fees for covered diagnostic, preventive, basic, cast and crown benefits provided that the eligible enrollee has these services furnished by a dentist participating in the Delta Preferred Option (DPO) program through Delta Dental Plan of California. If the services are provided by a non-participating provider, covered benefits will only reimbursed at 50 percent.
For further information, please consult the Dental Plan Document for complete details.
To review a summary of your Plan benefits, please select either the Delta Premier Summary or the Delta Preferred Option Summary listed above. (Requires Adobe Acrobat Reader to view either the Plan Documents or the Plan Summaries.)