Benefits at a Glance

Delta Dental is the carrier for our self-funded Dental Plan.

Save with PPO

Visit a dentist in the PPO network to maximize your savings. These dentists have agreed to reduced fees, and you won’t get charged more than your expected share of the bill. Find a PPO dentist at deltadentalins.com.

Eligibility

All full-time employees working 75% (or 100% in the case of bus drivers) of assigned full-time position per week are eligible for coverage the first of the month following one calendar month of continuous employment. Legally married spouses and eligible dependent children to age 26.

Benefits at a Glance

Benefits and Covered Services

  • Diagnostic & Preventive
  • Services (D & P)
    • Exams, cleanings and x-rays
  • Basic Services
    • Fillings, posterior composites,
    • simple tooth extractions, sealants and denture repair
    • Endodontics (root canals)
    • Periodontics (gum treatment)
    • Oral Surgery
    • General anesthesia
  • Major Services
    • Crowns, inlays, onlays and cast restorations
  • Implants
    • Bridges and dentures
    • No waiting period
  • Orthodontic Benefits
    • Adults and dependent children
    • No waiting period
  • MPD – TMJ Benefits

Useful Information from Delta

Plan Design

The plan pays 100% of the first $400.00 of expenses, then 50% of the next $1,600.00 of expenses.

Annual maximum is $1,200 per person each calendar year

Delta Dental PPO Plan Summary flyer

Rates

Calhoun City Schools provides dental insurance for all eligible employees and pays for the Employee Only amount on all tiers of coverage.

2024 MONTHLY PREMIUM

Coverage Tier Employee Cost Employer Pays Total Cost
Employee Only $0.00 $29.14 $ 29.14
Employee + Spouse $32.40 $ 29.14 $61.54
Employee + Child(ren) $48.62 $ 29.14 $77.76
Family $70.64 $ 29.14 $99.78

If both parents are employees, only one parent can cover children to age 26 and employees cannot be covered as both an employee and a dependent.

Contact

Set up an online account

Get information about your plan anytime, anywhere by signing up for an online account at deltadentalins.com. This useful service, available once your coverage kicks in, lets you check benefits and eligibility information, find a network dentist and more.

Check in without an ID card

You don’t need a Delta Dental ID card when you visit the dentist. Just provide your name, birth date and enrollee ID or Social Security number. If your family members are covered under your plan, they will need your information. Prefer to take a paper or electronic ID card with you? Simply log in to your account https://www.deltadentalins.com/, where you can view or print your card with the click of a button.

Claims

Claims Address
P.O. Box 1809
Alpharetta, GA 30023-1809

Delta Dental Claim Form

Customer Service- 800-521-2651

Plan Documentation

Certificate of Coverage