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FOR INFORMATION: Contact Nour Sayegh at 800-272-7732, Extension 6212
Delta Enrollment Form: Click HERE!
This dental program is Delta Premier, which is a scheduled dental assistance program. The program was previously referred to as Delta Adaptable. The Benefits of the Premier plan mirror the Adaptable plan.
As a PSEA Associate member, or surviving spouse, you are eligible to join the Delta Premier dental plan. Your eligible dependents include your spouse and unmarried children to age 19, or to age 23 if enrolled as full-time student.
Most affordable dental programs restrict your choice of dentists to one from a limited network. But with Delta Premier, you may go to any licensed dentist, anywhere in the world. You and your covered dependents can even choose to go to different dentists.
To use your Delta Premier benefits, simply make an appointment
with the dentist of your choice, and give the office your group number (7655-001) and your social security number.
Although you may choose any dentist, you get special advantages when you go to one of the more than 17,000 Delta dentists in California. These dentist have agreed to handle all your claims paperwork for you. Delta reimburses these dentists directly, so you are responsible only for the allowed amount not covered by the table. If you go to a non-Delta dentist, you are responsible for the entire bill and will receive reimbursement from Delta.
Your calendar year deductible is $25.00 per person, up to a maximum of $75.00 for the family. There is no deductible on diagnostic and preventive services for each covered enrollee per calendar year.
This is only a brief summary of the plan. Refer to the dental health plan contract to determine the exact terms and conditions of coverage. An Evidence of Coverage will be sent to you upon enrollment.
If you need more information before enrolling, call 1-800-272-7732 X 6212.
PLAN BENEFIT SUMMARY
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