Dental
Overview
Dental Benefits are available to Participants and eligible Dependents of Plan A, B, R and the Flat Rate Plan, whether enrolled in the Indemnity Medical Plan or the Kaiser HMO Plan. Dental benefits are administered by Delta Dental of California.
Your dental benefits are structured to provide an incentive to use dentists that belong to the Delta Dental Preferred Provider (PPO) network. You are free to use any licensed dentist but your out-of-pocket costs will be lower if you choose a Delta Dental PPO dentist.
To find a Delta PPO dentist, call Delta Dental at (844) 847-9516 or visit www.deltadentalins.com.
Dental Claims
Any claims for dental benefits should be sent directly to Delta Dental at the following address:
Delta Dental Plan of California
PO Box 997330
Sacramento CA 95889-7330
Orthodontic Benefits
Orthodontic benefits are payable at 50% of Allowed Charges and are paid in one lump sum, up to $1,500 (lifetime maximum) per Dependent child. Orthodontic benefits are provided only to Dependent children under age 19.
Orthodontic claims should be sent to Delta Dental at the following address:
Delta Dental Plan of California
PO Box 997330
Sacramento CA 95889-7330
Summary Plan Description / Rules & Regulations - Active Plans (A, B, R, Flat Rate)