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DENTAL INSURANCEPROGRAMS FOR
MEMBER AGENCIES OF CCSNYS
Presented by: Jenny SardiBenefits Specialist, Council Services Plus, Inc.
Programs Available
Dental PPO (Preferred Provider Plan) offered through CCSNYS’ Delta Dental PPO Plan A traditional dental insurance plan with
your choice of Dentists. Delta Dental DentalCare
Designed similar to an HMO, you must choose a network dentist.
Prepaid Dental Plan.
CCSNYS Group Number 1431
Delta Dental Preferred Plan
Delta Preferred Plan
Eligibility- Any Member Agency of CCSNYS that has
been a member for at least 60 days may enroll in the PPO Dental on the first of any month after signing a group contract with CCSNYS
50% of eligible employees must enroll in the Dental Plan. Eligible employees must work a minimum of 20
hours a week Employees who do not elect coverage because
they have Dental through another source are counted toward the 50% eligibility.
DeltaPreferred Plan
Plan covers:Dental Services Paid by Delta
Diagnostic 90%
Preventive 90%
Basic Restorative 80%
Oral Surgery 70%
Endodontic 70%
Periodontic 50%
Major Restorative 50%
Orthodontics 50%
TMJ 50%
Maximums: $2000 per person per calendar year.
Orthodontics has a separate maximum of $1250 lifetime per patient.
Deductible: $50 per person per calendar year. Maximum of $150 per family per calendar year. Does not apply to Diagnostic and Preventative care.
Delta Preferred PlanCovered Benefits:
Diagnostic: Procedures to assist dentists to evaluate existing conditions and dental care required - to include visits, exams, diagnosis and x-rays (exams & bitewing x-rays are benefits twice in any twelve month period.
Preventive: Prophylaxis (cleaning is a benefit twice in any twelve month period), fluoride treatments (limited to age 19), space maintainers, sealant (to age 14, once in every 36 months on unfilled permanent first and second molars).
Basic Restorative: Amalgam and composite fillings.
Major Restorative: Crowns, inlays, onlays are benefited where above materials are not adequate.
Oral Surgery: Extraction and oral surgery procedures including pre- and post-operative care.
Endodontics: Procedures for pulpal therapy and root canal filling.
Periodontal: Surgical and non-surgical procedures for treatment of gums and supporting structures of teeth.
Orthodontics: Procedures for straightening teeth (orthodontics is a benefit for dependent children to age 19).
TMJ: Reversible procedures for treatment of temporomandibular joint dysfunction.
Delta Preferred Plan Participants can go to see any dentist, but receive the
best rates from Delta Preferred Plan Dentist.
Preferred Dentist
Premier Dentist
Non Delta Dentist
Dentist Bill $180.00 $180.00 $180.00
Dentist Accepts
$90.00 (agreed on fee)
$130.00 (agreed on fee)
$180 .00 (no fee agreement)
Delta Payment
$81.00 $81.00 $81.00
Patient Share
$9.00 $49.00 $99.00
Patient Savings
$90.00 $60.00 $0
DeltaPreferred Plan
To view a list of providers in your area go to www.deltadental.com then: Choose New York Click on “Dental Search” under the heading
“Looking for a Dentist” Under “Product Selection,” chose the Delta
Dental PPO plan Complete the demographic information to
get a list of dentists.
Delta Preferred Plan
The rates
Individual- $31.36 per month Individual + One- 81.22 per month Family- $104.40 per month
CCSNYS Group Plan 1721
Delta Dental DeltaCare Plan
Delta Dental DeltaCare
Eligibility Active members of CCSNYS may enroll in
the DeltaCare Plan on the first of the month after signing a contract with CCSNYS.
Eligible employees must work a minimum of 20 hours a week.
ParticipationThere is no participation requirements for this
plan. As few as one employee can enroll for coverage Coverage is even available to members with
only one employee
Delta Dental DeltaCare
Services Covered by the plan include: Diagnostic – covered in full Preventive – covered in full Restorative – some procedures are covered in full Endodontic Periodontal Prosthodontics Orthodontics – copay of $180o for most adolescents.
There are no Maximums or Deductibles
A full listing of co-pays are available from CCSNYS
Delta Dental DeltaCare
DeltaCare Coverage is based on the HMO model
Each service performed has an associated co-pay that is payable to the dentist at the time of service.
Diagnostic, preventative and some basic restorative procedures are covered in full by this plan.
Delta Dental DeltaCare
Participants must choose a dentist from the DeltaCare directory.
To view a list of providers in your area go to www.deltadental.com and: Choose New York Click on “Dental Search” under the heading
“Looking for a Dentist” Under “Product Selection,” choose the
“DeltaCare USA” Complete the demographic information to get a
list of dentists.
Delta Dental DeltaCare
The rates Individual - $30.10 Individual plus One - $45.45 Family - $62.42
Delta Dental DeltaCare
Member Agencies may enroll in the DeltaCare program on the 1st of the month following the receipt of a signed contract, providing the contract and enrollment forms are received by the 15th of the month.
The DeltaCare program is a prepaid dental plan. DeltaCare pays a monthly fee to the primary care dentist listed on the enrollment form. Timeframes are strictly enforced by DeltaCare.
Termination forms must also be received by the 15th of the month prior to the termination date. There are no retroactive terminations allowed.
CCSNYS Administered Insurance Programs
Dental Program Administration
Administrative Highlights
CCSNYS Provides All the Administration for the Dental Coverage
If you have the health or life insurance through the CCSNYS Plans, your Dental Insurance Premium will be billed on the same invoice as the health or dental (monthly invoices).
By having one administrator your service will be personalized.
You can add Dental Coverage at anytime throughout the year, and still maintain your January 1 renewal date.
CCSNYS provides all the enrollment material you need at the annual open enrollment meeting held each November.
Communication of any changes implemented by the carrier will be communicated to you from CCSNYS.
Questions??
Who to call for applications and more info?Jenny Sardi x 129
[email protected] Laughlin x 128
Insurance Programs for Members of CCSNYS
