Dental
Delta Dental of Kansas
Great oral health is an essential part of a healthy lifestyle. Oral health is often overlooked, but regular oral care can help prevent common diseases and greatly influence your overall quality of life. We offer two dental insurance plans through Delta Dental to help you maximize your oral health. Visit www.deltadentalks.com to find a provider, print ID cards, check your eligibility or claims status, and more!
Plan Information
Base Plan
Buy-Up Plan
Network
PPO or PREMIER
Out-of-Network
PPO or PREMIER
Out-of-Network
$1,500 Per Calendar Year $0 Individual | $0 Family Plan pays 100% (PPO) Plan pays 70% (PREMIER)
$1,500 Per Calendar Year
$1,500 Per Calendar Year $50 Individual | $150 Family Plan pays 100% (PPO) Plan pays 70% (PREMIER) Plan pays 80% (PPO) Plan pays 70% (PREMIER) Plan pays 50% (PPO) Plan pays 50% (PREMIER)
$1,500 Per Calendar Year $50 Individual | $150 Family
Maximum Benefit(s) Per Person
Deductible (Applies to Basic & Major Services) Preventive (Oral Exams, X-Rays, Cleanings, Topical Fluoride, Space Maintainers, Sealants)
$0
Plan pays 60%
Plan pays 60%
Basic Services (Oral Surgery, Extractions, Restorative Services, Endodontics, Periodontics)
Not Covered
Not Covered
Plan pays 50%
Major Services (Special Restorative Services, Bridges, Dentures, Implants*, TMJ**)
Not Covered
Not Covered
Plan pays 40%
*Implant services are subject to a maximum benefit of $2,500 per lifetime, per person. Implant coverage will not be included in the annual maximum benefit. **Temporomandibular Joint Dysfunction is subject to the annual benefit maximum of $1,500 per person, per calendar year.
Base Plan Premiums
Annually
Monthly
Bi-weekly (20)
Bi-weekly (26)
Employee Only
$0
$0
$0
$0
Employee + Spouse
$0
$0
$0
$0
Employee Child(ren)
$0
$0
$0
$0
Employee Family
$0
$0
$0
$0
Buy-Up Plan Premiums
Annually
Monthly
Bi-weekly (20)
Bi-weekly (26)
Employee Only
$189.84
$15.82
$9.49
$7.30
Employee + Spouse
$398.64
$33.22
$19.93
$15.33
Employee Child(ren)
$360.60
$30.05
$18.03
$13.87
Employee Family
$588.48
$49.04
$29.42
$22.63
Employee Benefits Guide - 19
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