Notice

Happy Thanksgiving! Our offices will be operating during normal call center hours from 8:00 AM to 5:00 PM ET on Wednesday, November 27th. We will be closed on Thursday, November 28th and Friday, November 29th to allow our associates time to spend with their families and loved ones. We wish you a wonderful holiday filled with gratitude and joy!


We apologize for any inconvenience this may cause. Please self-service by signing into your account or using our Interactive Voice Response System (IVR) 24/7 at 800-452-9310.

Voluntary plan options within our Delta Dental PPO™ network

Find the PPO Voluntary plan with P&D, Basic, and Major Services that's best for your 2-9 enrolled group, including new Voluntary options

PPO Voluntary 1

P&D only option
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Starting at
$11.23*
Benefit Summaries
PPO calendar year maximum$500 or $750

per enrollee
Premier & OON calendar year maximum$500 or $750


per enrollee
Deductible$0
Per person/per family (excluding P&D)
    Preventive & Diagnostic
Oral exams/evaluations100%
2 per calendar year
Cleanings100%
2 per calendar year
Bitewing X-rays100%
2 per calendar year (through age 18); 1 per calendar year (19+)
Full mouth X-rays100%
1 per 5 years
Sealants100%
Once in a 24-month period per tooth (through age 14)
Topical Fluoride100%
2 per calendar year (through age 18)
Space maintainers100%
1 per arch per lifetime (through age 13)
    Basic Services
FillingsNot covered

 
Composite/resin restorationsNot covered

 
Simple extractionsNot covered
 
Root canal therapyNot covered
 
Periodontal maintenanceNot covered
 
Scaling and root planingNot covered
 
Periodontal surgeriesNot covered
 
Oral surgeryNot covered
 
   Major Services
Single crownsNot covered
 
Stainless steel crownsNot covered
 
Crown inlay, only and veneer repairsNot covered
 
Crown replacementNot covered
 
Post and coreNot covered
 
InlaysNot covered

 
ImplantsNot covered

 
BridgesNot covered

 
Dentures (complete and partials)Not covered

 
OrthodonticsNot covered

 
Waiting PeriodsNone
Plan Details Collapse

PPO Voluntary 6

100/80/0 plan options
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Starting at
$28.76*
Benefit Summary
PPO calendar year maximum$1,000 or $1,250

per enrollee
Premier & OON calendar year maximum$1,000 or $1,250


per enrollee
Deductible$50/$150
Per person/per family (excluding P&D)
    Preventive & Diagnostic
Oral exams/evaluations100%
2 per calendar year
Cleanings100%
2 per calendar year
Bitewing X-rays100%
2 per calendar year (through age 18); 1 per calendar year (19+)
Full mouth X-rays100%
1 per 5 years
Sealants100%
Once in a 24-month period per tooth (through age 14)
Topical Fluoride100%
2 per calendar year (through age 18)
Space maintainers100%
1 per arch per lifetime (through age 13)
   ; Basic Services
Fillings80%
Repeat restorations of same surface payable once in 2 years
Composite/resin restorations80%
Composite resin restorations will be covered on all teeth
Simple extractions80%
1 per lifetime per tooth
Root canal therapy80%
1 per lifetime per tooth
Periodontal maintenance80%
2 per calendar year
Scaling and root planing80%
1 per 2 years per quadrant
Periodontal surgeries80%
1 per 3 years per quadrant
Oral surgery80%
Frequencies vary by procedure code
    Major Services
Single crownsNot covered
 
Stainless steel crownsNot covered
 
Crown inlay, only and veneer repairsNot covered
 
Crown replacementNot covered
 
Post and coreNot covered
 
InlaysNot covered
 
ImplantsNot covered

 
BridgesNot covered
 
Dentures (complete and partials)Not covered
 
OrthodonticsNot covered
 
Waiting PeriodsMay apply
If no previous comprehensive coverage exists
Plan Details Collapse

PPO Voluntary 2

100/80/50 plan options
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Starting at
$39.98*
Benefit Summaries
PPO calendar year maximum$1,000, $1,500, or $2,000
per enrollee
Premier & OON calendar year maximum$1,000, $1,500, or $2,000
per enrollee
Deductible$50/$150
Per person/per family (excluding P&D)
    Preventive & Diagnostic
Oral exams/evaluations100%
2 per calendar year
Cleanings100%
2 per calendar year
Bitewing X-rays100%
2 per calendar year (through age 18); 1 per calendar year (19+)
Full mouth X-rays100%
1 per 5 years
Sealants100%
Once in a 24-month period per tooth (through age 14)
Topical Fluoride100%
2 per calendar year (through age 18)
Space maintainers100%
1 per arch per lifetime (through age 13)
                Basic Services
Fillings80%
Repeat restorations of same surface payable once in 2 years
Composite/resin restorations80%
Composite resin restorations will be covered on all teeth
Simple extractions80%
1 per lifetime per tooth
Root canal therapy80%
1 per lifetime per tooth
Periodontal maintenance80%
2 per calendar year
Scaling and root planing80%
1 per 2 years per quadrant
Periodontal surgeries80%
1 per 3 years per quadrant
Oral surgery80%
Frequencies vary by procedure code
                Major Services
Single crowns50%
Replacement 1 in 5 years against itself
Stainless steel crowns50%
Replacement 1 in 2 years
Crown inlay, only and veneer repairs50%
No frequency limitations
Crown replacement50%
Payable 6 months after insertion then 1 in 12 months
Post and core50%
Replacement 1 in 5 years
Inlays50%
Given alternate benefit of a composite filling
Implants50%
Once every 60 months per tooth for ages 16 and older
Bridges50%
1 per 5 years (abutment crowns and pontics)
Dentures (complete and partials)50%
1 placement per 5 years
OrthodonticsNot covered
 
Waiting PeriodsMay apply
If no previous comprehensive coverage exists
Plan Details Collapse

PPO Voluntary 5

100/50/50 voluntary options
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Starting at
$40.66*
Benefit Summary
PPO calendar year maximum$1,000, $1,500, or $2,000
per enrollee
Premier & OON calendar year maximum$1,000, $1,500, or $2,000
per enrollee
Deductible$50/$150
Per person/per family (excluding P&D)
    Preventive & Diagnostic
Oral exams/evaluations100%
2 per calendar year
Cleanings100%
2 per calendar year
Bitewing X-rays100%
2 per calendar year (through age 18); 1 per calendar year (19+)
Full mouth X-rays100%
1 per 5 years
Sealants100%
Once in a 24-month period per tooth (through age 14)
Topical Fluoride100%
2 per calendar year (through age 18)
Space maintainers100%
1 per arch per lifetime (through age 13)
                Basic Services
Fillings50%
Repeat restorations of same surface payable once in 2 years
Composite/resin restorations50%
Composite resin restorations will be covered on all teeth
Simple extractions50%
1 per lifetime per tooth
Root canal therapy50%
1 per lifetime per tooth
Periodontal maintenance50%
2 per calendar year
Scaling and root planing50%
1 per 2 years per quadrant
Periodontal surgeries50%
1 per 3 years per quadrant
Oral surgery50%
Frequencies vary by procedure code
                Major Services
Single crowns50%
Replacement 1 in 5 years against itself
Stainless steel crowns50%
Replacement 1 in 2 years
Crown inlay, only and veneer repairs50%
No frequency limitations
Crown replacement50%
Payable 6 months after insertion then 1 in 12 months
Post and core50%
Replacement 1 in 5 years
Inlays50%
Given alternate benefit of a composite filling
Implants50%
Once every 60 months per tooth for ages 16 and older
Bridges50%
1 per 5 years (abutment crowns and pontics)
Dentures (complete and partials)50%
1 initial placement per 5 years
OrthodonticsNot covered
 
Waiting PeriodsMay apply
If no previous comprehensive coverage exists
Plan Details Collapse

PPO Voluntary 3

100/80/50 plan options
More Details
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Starting at
$40.98*
Benefit Summary
PPO calendar year maximum$1,000, $1,500, or $2,000
per enrollee
Premier & OON calendar year maximum$1,000, $1,500, or $2,000
per enrollee
Deductible$50/$150
Per person/per family (excluding P&D)
    Preventive & Diagnostic
Oral exams/evaluations100%
2 per calendar year
Cleanings100%
2 per calendar year
Bitewing X-rays100%
2 per calendar year (through age 18); 1 per calendar year (19+)
Full mouth X-rays100%
1 per 5 years
Sealants100%
1 per lifetime per tooth (through age 14)
Topical Fluoride100%
2 per calendar year (through age 18)
Space maintainers100%
1 per arch per lifetime (through age 13)
                Basic Services
Fillings80%
Repeat restorations of same surface payable once in 2 years
Composite/resin restorations80%
Composite resin restorations will be covered on all teeth
Simple extractions80%
1 per lifetime per tooth
Root canal therapy80%
1 per lifetime per tooth
Periodontal maintenance80%
2 per calendar year
Scaling and root planing80%
1 per 2 years per quadrant
Periodontal surgeries80%
1 per 3 years per quadrant
Oral surgery80%
Frequencies vary by procedure code
                Major Services
Single crowns50%
Replacement 1 in 5 years against itself
Stainless steel crowns50%
Replacement 1 in 2 years
Crown inlay, only and veneer repairs50%
No frequency limitations
Crown replacement50%
Payable 6 months after insertion then 1 in 12 months
Post and core50%
Replacement 1 in 5 years
Inlays50%
Given alternate benefit of a composite at the restorative copay
Implants50%
Once every 60 months per tooth for ages 16 and older
Bridges50%
1 per 5 years (abutment crowns and pontics)
Dentures (complete and partials)50%
1 initial placement per 5 years
OrthodonticsNot covered
 
Waiting PeriodsNone
 
Plan Details Collapse
* These are benefit highlights only. Additional exclusions and limitations may apply. Monthly premiums shown are examples only of our lowest monthly rates per employee for employee only coverage. Actual rates vary based on plan choice, your location, and number of people insured. For full details of plans, benefits and pricing, please contact one of our account executives.