Introduction
We offer dental coverage through the Marathon Petroleum Dental Plan (the Dental Plan). Under the plan, you can receive care from any licensed dentist; however you will save money when you visit a dentist in the Delta Dental network, since these dentists have agreed to give plan members the largest discounts.
Dental Plan Information for Active Employees
When you visit a network dentist, the plan pays all or a portion of the negotiated cost of the service. When you visit an out-of-network dentist, the plan pays all or a portion of the Reasonable and Customary (R&C) charge*.
| Delta Dental PPO and Premier Networks |
| Annual Deductible: $50 per person |
| Calendar Year Maximum (not including orthodontia): $2,000 per person |
| Type of Service |
Service Examples |
Coverage |
| Preventive and Diagnostic |
Exams (limited to two per year), x-rays |
100%*† (no deductible) |
| Basic Dental Services |
Fillings, extractions, root canals |
80%* (after deductible) |
| Major Dental Services |
Inlays, crowns, dentures |
50%* (after deductible) |
Orthodontia Services
(lifetime maximum: $2,000 per person) |
Traditional Metal Braces |
50%* (after deductible) |
*Of Reasonable and Customary (R&C) Charge when using an out-of-network provider. R&C is determined by the average usual charge for a given procedure charged by most dentists in a given geographic area.
†$50 individual deductible does not apply to preventive services.
Dental Plan Information for Pre-65 Retirees
When you visit a Delta Dental PPO Network dentist, the plan pays all or a portion of the negotiated cost of the service. When you visit a Premier Network or an out-of-network dentist, the plan pays all or a portion of the Reasonable and Customary (R&C) charge*.
| Dental Plan PPO |
| Annual Deductible: $50 per person |
| Calendar Year Maximum: $1,000 per person |
| Type of Service |
Service Examples |
Coverage |
| Preventive and Diagnostic |
Exams (limited to two per year), x-rays |
100%*† (no deductible) |
| Basic Dental Services |
Fillings, extractions, root canals |
80%* (after deductible) |
| Major Dental Services |
Inlays, crowns, dentures |
50%* (after deductible) |
| Ortnodontia Services |
Not covered |
Not covered |
*Of Reasonable and Customary (R&C) Charge when using a Premier Network or an out-of-network dentist. R&C is determined by the average usual charge for a given procedure charged by most dentists in a given geographic area.
†$50 individual deductible does not apply to preventive services.
Dental Plan Rate for Pre-65 Retirees
Retirees under age 65 are eligible for dental coverage that is similar to the coverage provided to MPC active employees. The individual calendar year maximum is different for pre-65 retirees, and so are the contribution amounts for coverage. For information on monthly contributions for COBRA coverage under the active dental plan, see COBRA Rates.
Under this Plan, you are encouraged to receive care from a dentist in the Delta Dental PPO Network, or the Delta Dental Premier Network.
| Pre-65 Retiree Dental Plan – 2019 Monthly Contributions |
| Retiree Only |
Retiree + Spouse |
Retiree + Children |
Retiree + Family |
| $23 |
$46 |
$50 |
$79 |