Through Delta Dental's national network of providers, PEBB members who reside out of state have access to more than 154,000 in-network Delta Dental Premier providers and more than 113,000 PPO in-network providers nationwide.

Under an incentive dental plan, benefits start at 80% for in-network benefits during the first plan year of coverage. Payments increase by 10% in each subsequent plan year (up to a maximum benefit of 100%) provided you have visited the PPO dentist at least once during the previous plan year. If you did not visit a PPO dentist in the previous plan year there will be a 10% reduction in payment in the new plan year. Payment will never fall below 80% for in-network benefits.

Please note, this plan includes incentive-based benefits for restorative (basic) services only.

Prophylaxis (cleaning) or periodontal maintenance is covered twice per year.

Yes. There is a $50 deductible on all Delta Dental plans. The deductible is waived for preventive services.

No. If youmove from a constant plan (Full Time or Part Time Premier Plan) to an incentive plan (Full Time PPO Plan) your incentive level starts at 80% for in-network benefits, regardless of their original date of hire.

If you have dual Delta Dental coverage under PEBB with a plan maximum (e.g., PPO Plan with $1,750 plan-year maximum), the primary plan will pay first. The secondary plan will pick up balances on allowable expenses.

Once you have met your maximum on the primary plan ($1,750 has been paid out), then the secondary plan will pay, as if it is primary, until it has also met the $1,750 maximum (dollars paid as secondary, prior to the primary maximum being met, also apply toward the secondary $1,700 maximum).

Example:

You are at the 80% incentive level under both plans and have the full maximum benefit ($1,750) available under both plans. You have a cleaning by an in-network provider and there are no prior cleanings submitted to Delta Dental within the frequency limit. The provider's charge is $100 for the cleaning and the charge is within the maximum plan allowance. The primary plan would issue a benefit of $70 and then the secondary plan would coordinate benefits and issue a benefit of $30.

You will have used $70 of your maximum under your primary plan and $30 under the secondary plan.

If you have dual Delta Dental coverage under PEBB with a plan maximum (e.g., PPO Plan with $1,750 plan-year maximum), the primary plan will pay first. The secondary plan will pick up balances on allowable expenses.

When you visit a dentist who is in the Delta Dental Premier® Network or the Delta Dental PPO(SM) Network, you will not be billed for charges over the contracted fees. As a Delta Dental participating provider, the provider will write off the amount that is billed over the contract allowance.

A secondary Delta Dental plan, will pay up to the highest allowable charge between the plans, not to exceed the billed amount. If there is a charge over the allowed amount (for example,due to seeing a provider that is out of network with one or both of the plans), youwould be responsible for the extra charge.