Dental Plans

BENEFIT
DELTA CORE PPO*
DELTA ENHANCED PPO*
Annual Deductible** (Individual/Family)

$50 / $150

$50 / $150

Annual Plan Maximum
$1,000 per person
$1,500 per person
Diagnostic & Preventive Services (exams, routine cleaning, x-rays, fluoride treatment, sealants)
Plan pays 100% (deductible waived)
Plan pays 100% (deductible waived)

Basic Services (fillings, root canals, oral surgery, non-surgical periodontics, denture repair, relining)

Plan pays 80% (after deductible)
Plan pays 80% (after deductible)
Major Services (osseous surgery, crowns, inlays, onlays, cast restorations, bridges, dentures)
Not covered
Plan pays 50% after deductible)
Orthodontia Services (Child)
Not covered
Plan pays 50%
Ortho Lifetime Max
N/A
$1,500

Good dental health is important to your overall well-being. At the same time, we all need different levels of dental treatment. It is for this reason that Clario offers two dental plans: Delta Core PPO and the Delta Enhanced PPO, through Delta Dental of PA.

The Delta Dental PPO Plus Premier Network offers a balance of savings and choice each time you seek covered dental care. You may visit any dentist of your choice; however, if you choose to use a provider that is not a part of the Delta Dental Plus Premier network, you will likely pay more for covered services.

*For services obtained outside the network, Delta Dental has established a "Maximum Allowable Charge" (MAC) for all services. Delta Dental will reimburse out-of-network providers up to the established MAC. Out-of-network providers can then bill participants the differences between Delta Dental's MAC and their actual charge for the service.

**The annual deductible applies to Basic and Major Services only.

Dental Plan Documents

Benefit Summary
Certificate of Coverage
Click here for more Delta Dental information
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