Delta Dental

AACET is offering Delta Dental

Great benefits!  (Click here to download a file that lists benefits)

 

Delta Dental PPO Plus Premier

Schedule of Benefits for Arkansas Association of Correctional Employees

Deductible$25 for benefits received in Coverage B or Coverage C per person, per benefit period. There is no deductible on Coverage A.  

Benefit Period: A benefit period for each eligible participant shall mean a calendar year, the period from January 1st to December 31st of each year.

 

Covered Services: Coverages and Maximum Plan Allowances (MPA)

Coverage A – Diagnostic and Preventative Services

In-Network

100% MPA

Routine periodic examinations not more than two (2) in any benefit period, inclusive of an initial oral examination.

Bitewing and periapical X-rays as required.

Full-mouth X-rays one (1) in any sixty (60) consecutive month period.

 

Prophylaxis (cleaning) not more than two (2) in any benefit period (* Please see Information on Evidence Based Dentistry Below).

 

Topical application of fluoride once (1) per benefit period for dependent children to age nineteen (19).

 

Sealants once (1) per tooth on permanent maxillary and mandibular first and second molars with no caries (decay) on the occlusal surface, for dependent children to agesixteen (16).

Coverage B – Basic Restorative Services

In-Network

80% MPA

Minor emergency treatment for the relief of pain as needed by the participant.

 

Amalgam (silver) and composite/resin (white) fillings.

 

Simple Extractions.

 

Space maintainers for prematurely lost teeth of eligible dependent children to agefourteen (14).

 

Stainless steel crowns used as a restoration to natural teeth for dependent children to age sixteen (16) when the teeth cannot be restored with a filling material.

 

Coverage C – Major Restorative Services

In-Network

50% MPA

Oral surgery, including pre- and post-operative care and surgical extractions, except TMJ surgery

 

Endodontics, including pulpal therapy and root canal filling.

 

Crowns, inlays, onlays, and veneers are benefits for the treatment of visible decay and fractures of tooth structure when teeth are so badly damaged they cannot be restored with amalgam or composite restorations.

 

Prosthodontics, including procedures for construction of fixed bridges, partial or complete dentures, and repair of fixed bridges.

 

Complete or partial denture reline, including chair side or laboratory procedures to improve the fit of the appliance to the tissue.

 

Complete or partial denture rebase, including laboratory replacement of the acrylic base of the appliance.

 

Surgical periodontics.

 

Non-surgical periodontics

Periodontal maintenance; two (2) per benefit period following active periodontal treatment (* Please see Information on Evidence Based Dentistry Below).

 

Coverage for an Endosteal Implant to support a crown.

Rider(s)

Carry Over Benefit Rider

Carry Over Benefit: $375

Claims Threshold: $749

Carry Over Benefit Maximum: $1,500

Rider(s)

Child Orthodontic Rider – Orthodontic services for dependent children to age nineteen (19).

Lifetime Maximum Payment :$1,000 In Network 50% MPA

 

Child Orthodontia Rider*
* Coverage for Orthodontia Services for Dependent Children to Age Nineteen (19).
* Lifetime Maximum of $1,000 Per Dependent Child to Age Nineteen (19).
* Benefits Will be Extended to the Limiting Age for Full Time Students if the Adult Orthodontia Rider is Purchased.
* Deductible does not apply.

Please note that there is a pre-ex for ortho. This means that any dependent that has been banded prior to 9/1/2013 will not qualify for ortho benefits.

The initial payment made by DDAR for comprehensive treatment cannot be more than one-third (1/3) of the total fee for treatment. Subsequent payment(s) will be issued on a regular basis for continuing, active orthodontic treatment. Payment(s) will begin the month after the beginning of treatment. Payments are subject to the participants’ co-payment percentage and lifetime maximum. Orthodontia is considered a pre-existing condition if treatment begins prior to the date he/she became eligible under this plan.

The benefit allowance for services of an out-of-network dentist will be reduced by 10% for eligible services as determined by Delta Dental after applying the applicable deductibles, co-payments and maximums. This means your out-of-pocket expense may be greater if you choose an out-of-network dentist.

(*) DDAR covers additional routine cleanings or periodontal maintenance procedures (up to four per year) for covered members with diabetes, heart disease, who are pregnant or have a history of periodontal disease. The additional benefits may not be combined by those with more than one of the above conditions.

Questions? Contact Delta Dental’s Customer Service Department at (800) 462-5410.

Delta Dental’s network of participating providers may be found on our website at www.deltadentalar.com.

 

Affordable biweekly rates that are added to your AACET dues:

  • Employee only - $9.35
  • Employee + spouse - $20.53
  • Employee + child(ren) - $21.81
  • Employee + family - $30.30

 

See your Human Resources Manager or Benefits Specialist for AACET application and dental enrollment form or download from the Forms link. 


THIS INSURANCE IS NOT BEING OFFERED THROUGH THE STATE OF ARKANSAS.  DELTA VISION INSURANCE IS BEING OFFERED EXCLUSIVELY THROUGH AACET FOR AACET MEMBERS ONLY.