In the Pre-65 Retiree Dental Plan you can receive care from any licensed dentist. However, providers in the Delta Dental PPO network offer the greatest cost savings. Coverage levels are not the same as in the active
employee Dental Plan. Covered amounts are based on reduced contracted fees, referred to as “maximum allowable charges,” and are generally lower than those paid under the active employee Dental Plan. Providers in the Delta
Dental Premier network also offer large discounts but may balance bill you for charges not paid by the plan.
* This Plan is not open to new enrollment. Please check with the Benefits Service center on your eligibility.
*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
†$50 individual deductible does not apply to preventive services.