Dental Plan
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Delta Dental-Active Group
P.O. Box 997330
Sacramento, CA
95899-7330
Phone: (800) 765-6003
Website:
www.deltadentalca.org
Active
Group number: (2476-0001 + SSN)
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Delta Dental of California
The County provides a comprehensive dental plan for eligible full-time
and part-time employees and their enrolled dependents. The County pays
100% of the dental plan premium cost. As required by Federal tax law,
income will be “imputed” if your enrolled dependent is a domestic
partner or child of your domestic partner. Dental benefits are
effective on the first day of the month following receipt of your
completed enrollment application by the Employee Benefits Office.
Please refer to the
Employee Dental Plan booklet for specific coverage
information.
"REMEMBER 30 DAYS"
You must come to the Employee Benefits Office within 30 days of the date
of a qualifying status change event to make a change to your medical, dental and
life insurance. Failure to do so within the 30-day time frame will result in
your inability to make the change until the next Annual Enrollment period.
Even if you have other group dental coverage, you still must enroll in the
Sacramento County Employee Dental plan as your primary dental plan.
“Coordination of Benefits” rules will be applied in determining how benefits
will be paid. You may find that many dental services will be paid in full
between your two dental plans.
If you receive service from a
Delta PPO (formerly called DeltaPreferred Option)
dentist, the plan will pay 100% of the preventative and diagnostic
services; 90% of the basic services; and 80% for major services. If you receive
services from a non-PPO
Delta dentist who is not part of the DPO list, the plan will pay 80% of
preventative and diagnostic services; 80% for basic services; and 80% for major
services. If you receive services from a non-Delta dentist, the plan will pay
80% of covered services based upon “usual, customary, and reasonable” (UCR) fees
as defined by Delta Dental. Any amount over the UCR amount as well as the
percentage of UCR that is not paid by the plan is your financial
responsibility. An Evidence of Coverage booklet, that contains details about
the plan, is distributed to all employees upon hire and during annual
enrollment.
A list of DeltaPreferred Option Dentists and Delta Dentists can be obtained by
calling 1-800-765-6003
or logging
onto to Delta Dental’s website at
www.deltadentalca.org.
This list will identify those dentists who can provide care for individuals who
have mobility impairments or have special health care needs.
Inquire about the availability of documents in
alternate formats.
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