Dental
Dental coverage helps you maintain a healthy smile with preventive care, basic services, and major procedures. You can visit any licensed dentist, but you’ll save the most when you use an in-network provider who has agreed to discounted rates. Out-of-network dentists may charge more than the plan’s allowed amount, and you may be responsible for the difference. Most plans cover preventive services—such as exams, cleanings, and X-rays—at 100% when you stay in-network, making regular checkups an easy way to protect your oral health and avoid costly issues.
Delta Dental PPO Plan
Benefit Highlights
In-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Max (Individual/Family)
$2,000
Preventive Care
0%
Basic Services
10%*
Major Procedures
40%*
Orthodontia (Adults and Children)
50% after deductible up to a lifetime maximum benefit of $2,500 per individual
*After deductible
Premier & Out-of-Network
Deductible (Individual/Family)
$50/$150
Annual Plan Max (Individual/Family)
$2,000
Preventive Care
0%
Basic Services
20%*
Major Procedures
50%*
Orthodontia (Adults and Children)
50% after deductible up to a lifetime maximum benefit of $2,500 per individual
Semi-Monthly Plan Cost
Employee Only: $0.00
Employee and Spouse: $6.52
Employee and Child(ren): $9.05
Employee and Family: $15.56
HMSA Dental PPO Plan (Hawaii Only)
Benefit Highlights
In-Network
Deductible (Individual/Family)
$0/$0
Annual Plan Max (Individual/Family)
$1,500 per person
Preventive Care
0%
Basic Services
30%
Major Procedures
50%
Orthodontia (Adults and Children)
Not covered
Out-of-Network
Deductible (Individual/Family)
$0/$0
Annual Plan Max (Individual/Family)
$1,500 per person
Preventive Care
0%
Basic Services
30%
Major Procedures
50%
Orthodontia (Adults and Children)
Not covered
Semi-Monthly Plan Cost
HMSA dental plan costs included with HMSA medical plan.