Employee Benefits: Dental Plans

Eligibility

Regular full-time and regular part-time employees working 20 hours per week are eligible on the first day of the month after employment.

Cost

USP pays all or a substantial portion of the cost of the coverage. Employee pre-tax bi-weekly contributions are:

Coverage LevelGold PlanPlatinum Plan
Employee Only$0.00$8.67
Employee + 1$0.00$17.50
Employee + 2 or more$0.00$30.42

Amount of Benefit

A comprehensive dental program with Delta Dental allows maximum choice with coverage for diagnostic, preventive, basic, and major services.

Gold PPO—In- and Out-of-Network benefits: Click to expand

  • Annual per person in-network deductible for basic and major services; $50/person not to exceed $150/family
  • Annual per person out-of-network deductible for basic and major services; $100/person not to exceed $300/family
  • Deductible waived for in-network preventive services
  • Preventive services are covered at 100% in-network; 100% out-of-network
  • Basic services covered at 80% in-network; 60% out-of-network; and 60% of in-network fee schedule for non-participating dentists
  • Major services covered at 50% in-network; 30% out-of-network; and 30% of in-network fee schedule for non-participating dentists
  • Annual benefit maximum of $2,000 for preventive, basic and major services combined
  • Diagnostic & preventive maximum waiver ensures preventive services are covered even if the annual maximum is exceeded
  • In- and out-of-network providers available nationwide; allows you to visit the dentist of your choice
  • Pre-determination review for services and procedures over $300

Platinum PPO—In- and Out-of-Network benefits: Click to expand

  • Annual per person in-network deductible for basic and major services; $50/person not to exceed $150/family
  • Deductible waived for diagnostic, preventive and orthodontics
  • Diagnostic and preventive services are covered at 100% in-network; 100% out-of-network
  • Basic services covered at 90% in-network; 80% out-of-network; and 80% of in-network fee schedule for non-participating dentists
  • Major services covered at 60% in-network; 50% out-of-network; and 50% of in-network fee schedule for non-participating dentists
  • Annual benefit maximum of $2,000 for preventive, basic and major services combined
  • Diagnostic & preventive maximum waiver ensures preventive services are covered even if the annual maximum is exceeded
  • Orthodontia services covered at 50% in- and out-of-network to a lifetime maximum of $1,500 for child(ren) under age 19
  • In- and out-of-network providers available nationwide; allows you to visit the dentist of your choice
  • Pre-determination review for services and procedures over $300