Benefit Description

Dental benefits are provided through a contract with Delta Dental Plan of California. These benefits are provided to all participants and eligible dependents, regardless of which medical benefits option they have selected. A separate booklet is available from your Local Union Office or the Trust Fund Office which will explain the Plan’s dental benefits in detail.

When you use a Delta Dental Participating Dentist, you pay the designated portion of the covered charges, and payment will be made directly to the dentist by Delta Dental. Delta Dental Participating Dentists have agreed with Delta Dental not to charge you for any amount above the agreed charges for covered services and supplies, or for any sums owing by Delta Dental under this Plan. This rule does not apply to non-Delta dentists, so you will be responsible for any charges by a non-Delta dentist that the Plan does not pay.

The Plan will cover 80% of diagnostic and preventative benefits, basic benefits, crowns, jackets, and cast restoration benefits, and prosthodontic benefits. The plan covers 100% of these services for dependent children for Non-Residential group 79-2001.

Your deductible (which does not apply to diagnostic and preventative benefits) per patient per lifetime is $50, and $200 per family per lifetime.

Orthodontic benefits (for dependent children only) are covered at 50% with a lifetime maximum benefit per patient of $2,000.

Benefit Highlights

  • Non-Residential – Division 02001: Enrollee & Spouse PPO Plan
  • Non-Residential – Division 02001: Dependent Children PPO Plan
  • Residential – Division 02002: Enrollee, Spouse & Dependent Children PPO Plan

To get your benefits for covered dental care, tell your dentist of your eligibility under this Plan at the time of treatment, and provide the following information:
Delta Dental Group No.: 79-2001 or 79-2002 (Residential)
Group Name: UA Local 467
Your Social Security Number

Delta Dental ensures the benefits payable through the Plan. This means that the final decision on whether or not to pay a claim is up to Delta. To object to their initial decision on a claim, you must appeal under Delta’s own procedures. If you have questions about a claim, you may call Delta at their toll-free customer service number (888) 335-8227.

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