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Dental Plan

Delta Dental of Ohio is the dental plan provider.

The Delta Dental plan gives you access to two large networks of participating dentists – Delta Dental PPO and Delta Dental Premier. Your costs will be lower if your dentist is in the PPO network. In Ohio, more than 5,800 general dentists participate in these networks.

Eligiblity

You have to be eligible for, but you do not have to be enrolled in, SERS’ health care coverage to sign up for dental coverage. You must enroll in dental coverage in order to enroll your spouse and/or children.

Open Enrollment Period

Dental plan enrollments are accepted from Sept. 1 to Oct. 31 every year. Coverage begins on Jan. 1 of the following year.

You decide each year during open enrollment to keep, enroll in, or cancel dental coverage.

You also can cancel coverage at any time by submitting a cancellation request in writing.

Premiums

Dental premiums are deducted from monthly payments. When your payment is not enough to cover your SERS health care coverage and/or dental premiums, SERS will bill you for the outstanding balance.

2017 Dental Premiums:
Benefit recipient $27.81
Benefit recipient and one dependent* $55.62
Benefit recipient, and two or more dependents* $83.70

* A dependent can be a spouse or a child

Payment

Network dentists have agreed to accept Delta’s negotiated prices for various services. The percentages on the chart below show how much the plan pays. When a service is not covered at 100%, you pay the remaining portion.
 
Network dentists cannot charge you more than Delta’s negotiated prices. A non-participating dentist who charges more than the payment schedule can bill you the difference.
 
Dental Coverage Highlights
Delta Dental
Coverage effective Jan. 1, 2017
Final plan documentation prevails
PPO
Dentist
Premier
Dentist
Non-participating
Dentist*
DIAGNOSTIC AND PREVENTIVE (no deductible)
Exams, cleanings, fluoride, emergency pain relief, sealants, brush biopsy, bitewing and full-mouth X-rays 100% 80% 80%
BASIC SERVICES ($50 deductible applies)
Minor restorative services, including fillings, periodontics, other X-rays, and other basic services 80% 60% 60%
MAJOR SERVICES ($50 deductible applies)
Repair to individual crowns, molar root canals, oral surgery services, crowns; relines and repairs to bridges, dentures, and implants; prosthodontic services for bridges, implants, and dentures 50% 40% 40%

* When you receive services from a nonparticipating dentist, the percentages listed indicate the portion Delta Dental will pay for those services. The nonparticipating dentist fee paid by Delta may be less than what your dentist charges, and you are responsible for the difference.

Maximum Coverage – $1,500 per person per calendar year.

 

Locating a Network Dentist

To locate a network dentist near you:

  • Call your dentist’s office and ask if your dentist participates in the Delta Dental PPO or Premier network
  • Call Delta Dental’s customer service department toll-free at 800-524-0149
  • Visit Delta Dental’s online directory at www.deltadentaloh.com, and click on the “Find a Dentist” icon

Resources and Links

Frequently Asked Questions

Online Consumer Toolkit