PSEA offers group rates on dental insurance for retired and associate members, and surviving spouses.
We have four different plans from which to choose the one that is best for you and your family. Eligible dependents include your spouse and children up to age 26.
For your convenience, open enrollment takes place four times per year. Once you enroll in a plan, you may not change plans for twelve months. For this reason, we recommend that you thoroughly understand the differences in each plan and, if you wish to keep your current dentist, ask your dentist’s office if they take the specific plan you are interested in before applying.
Open enrollment for both dental and vision benefits occurs four times per year.
You will find enrollment forms on the plan description pages.
OPEN ENROLLMENT DATES
| Quarter | Open Enrollment | Close Enrollment | Effective Date |
|---|---|---|---|
| First Quarter | 11/1 | 12/7 | 1/1 |
| Second Quarter | 2/1 | 3/7 | 4/1 |
| Third Quarter | 5/1 | 6/7 | 7/1 |
| Fourth Quarter | 8/1 | 9/7 | 10/1 |
For an overview of the different plans, use the plan comparison chart below (or print a chart here). For specifics on each plan, use the links at the bottom of the page. Note: Basic services and major services may be defined differently in different plans. To understand these differences, refer to the plan brochure links on each plan page.
PLAN COMPARISON CHART
| Summary of Benefits | DeltaCare USA | PPO | Premier (Table of Allowance) | Guardian |
|---|---|---|---|---|
| Diagnostic & Preventive | Member pays $0-$35 | Member pays 0% for in-network, PPO dentists | Member pays difference between dentist charges and plan allowances | Member pays 0% for in-network and out-of-network dentists |
| Basic Services | Member pays $5-$250 | Member pays 20% for in-network, PPO dentists | Member pays difference between dentist charges and plan allowances | Member pays 20% for in-network dentists, 50% for out-of-network dentists |
| Major Services | Member pays $10-$250 | Member pays 50% for in-network, PPO dentits | Member pays difference between dentist charges and plan allowance | Member pays 40% for in-network dentists, 50% for out-of-network dentists |
| Orthodontia | Coverage for adults and children | Not covered | Not covered | Not covered |
| Annual Deductible | None | $25 for PPO dentists $50 for Premier dentists |
$25 per person $50 per person |
$50 per person $150 per family |
| Annual Maximum | None | $1250 per person | $1500 per person | $1000 per person |
| Waiting Periods | None | None | None | None |
| Copayments/Coinsurance | Covered procedures have predetermined copayments for services provided by network dentists | Covered services paid at applicable percentage | Covered services paid according to the plan table of allowance | Covered services paid at applicable percentage |
| Dentist Network | You select a dentist from a list of network dental facilities and you must visit this dentist to receive benefits | Freedom to choose any licensed dentist, selecting a PPO dentist will usually result in the lowest out-of-pocket costs | Freedom to choose any licensed dentist, selecting a Delta dentist will usually result in the lowest out-of-pocket costs | Freedom to choose any licensed dentist, selecting a PPO dentist will usually result in the lowest out-of-pocket costs |
| Out-of-Area Coverage | Limited to emergency care allowance | Visit and licensed dentist | Visit and licensed dentist | Visit and licensed dentist |
| QUARTERLY PREMIUM | ||||
| Member only | $132 | $180 | $153 | $132 |
| Member + 1 dependent | $219 | $348 | $273 | $246 |
| Member + 2 or more dependents | $327 | $621 | $399 | $378 |