Basic Plan
A lower-cost dental plan without orthodontia coverage.
2020 dental plans
You can enroll in the dental plan of your choice as a new hire, during Open Enrollment, or if you have a qualifying life event. To see your premiums and enroll, log in to the Acme Enrollment website.
Premium Plan
A dental plan with higher benefits, including coverage for orthodontia.
Key features at a glance
Our dental coverage provides:
Free in-network preventive and diagnostic care
to help keep your teeth healthy
Affordable coverage
that helps you manage the cost of dental treatment.
Wide network of providers
that have agreed to negotiated rates, which helps you save money.
Find a network dentist
You may choose to see any in- or out-of-network dentist you’d like, but you’ll generally pay less when you stay in network. Visit the Delta Dental website to find an in-network provider near you.
Coverage details
| In-network benefits* | Basic Plan | Premium Plan |
|---|---|---|
| Individual/family deductible | $50/$150 | $50/$150 |
| Annual maximum benefit | $1,000 | $2,000 |
| Services | ||
| Preventive | You pay $0 | You pay $0 |
| Basic | You pay 30%, plan pays 70% | You pay 20%, plan pays 80% |
| Major | You pay 50%, plan pays 50% | You pay 50%, plan pays 50% |
| Orthodontia (coinsurance/lifetime maximum) | Not covered | 50%/$2,500 |
*Note: If you visit an out‐of‐network provider, you are responsible for any charges above the usual, customary, and reasonable (UCR) limits.
Use your dental benefits wisely
Here’s how to make the most of your dental benefits:
Choose a network provider.
Each time you need dental care, you have a choice of providers. Selecting a Delta Dental participating dentist will ensure you receive the highest benefits from your plan. To find a provider, go to the Delta Dental website.
Present your plan identification.
Give your provider's office the information they need to bill your insurance. The group number is XXXXXXX and your member number is your Social Security number.
Submit for a pretreatment estimate.
You should submit a request for a pre-treatment estimate for procedures and services your dentist believes will exceed $300 (procedures such as crowns, inlays, bridges, and periodontics). For more information, call Delta Dental at 1-800-123-4567 or visit the Delta Dental website.
Check your claim status.
You can review Explanation of Benefits (EOB) statements, check if claims have been paid, and more on the Delta Dental website.