This is a PPO plan where benefits are based on a table of allowances.
The table lists the maximum amount the plan will pay for a given service, and you are responsible for the difference between what the plan pays and what your dentist charges for the service.
Most affordable dental programs restrict your choice of dentists to one from a limited network, but with Delta Premier, you may go to any licensed dentist, anywhere in the world. You and your covered dependents can even choose to go to different dentists.
Although you may choose any dentist, you get special advantages when you go to one of the more than 17,000 Delta dentists in California. These dentists have agreed to handle all your claim paperwork for you. Delta reimburses these dentists directly, so you are responsible only for the allowed amount not covered by the table. If you go to a non-Delta dentist, you are responsible for the entire bill and will receive reimbursement from Delta.
To use your Delta Premier benefits, simply make an appointment with the dentist of your choice and give the office your group number (07655-00001) and your social security number.
The program was previously referred to as Delta Adaptable or Delta Premier B.
Features/Benefits:
- You have the freedom to choose any licensed dentist.
- If you use a Delta dentist, there are no claim forms to complete.
- No plan ID cards are required.
- Delta Dental guarantees the work of its dentists.
| Rates | Quarterly Payment |
|---|---|
| Member Only | $153 |
| Member + 1 Dependent | $273 |
| Member + 2 or more Dependents | $399 |
If you have questions after reviewing the plan brochure, call Delta Dental at 1-800-765-6003. Group #07655-00001.
For enrollment questions, contact PSEA Retiree Benefits at
(925) 246-6212 or PSEARetireeBenefits@pge.com.
Use the “Apply Online” button above to apply during open enrollment. If it is not open enrollment and you wish to send an application to be processed for the next enrollment period, you may print the enrollment form and send it with your first quarter payment to 1390 Willow Pass Rd., Suite 240, Concord, CA 94520.
