Dental

Tri-County Schools Insurance Group (Group No. 7084) offers two very distinct dental programs through Delta Dental of California.
 

The first is the long standing, popular plan referred to as the Delta Premier Plan. Under this program, Delta pays 70% of the approved fees for covered basic services, restorations, and crown benefits during the first year you are eligible. This percentage will increase 10% each year (to a maximum of 100%) for each enrollee, provided that person visits the dentist at least once during the year. If any enrollee does not use the program during a calendar year, the percentage remains at the level reached the previous year. 

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In addition, enhancements of $500 were added to the Delta Dental program when you use the service of a Delta PPO dentist. For example, if you have an annual maximum of $2,000 you have an additional $500 to use above your annual maximum if you use a Delta PPO dentist for the additional $500 of work.

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The second option is referred to as the Delta Preferred Provider Option (PPO). Under this program, Delta pays 100 percent of the approved fees for covered diagnostic, preventive, basic, cast and crown benefits provided that the eligible enrollee has these services furnished by a dentist participating in the Delta Preferred Provider Option (PPO) program through Delta Dental Plan of California. If the services are provided by a non-participating provider, covered benefits will only reimbursed at 50 percent.

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Under both of the Dental Options, TCSIG has increased the benefits by providing the Diagnostic & Preventive Waiver. This means that your regular check-ups (exam, cleaning, x-ray) will not affect you annual maximum, which in essence gives you another $300 or $400 extra above your annual maximum.