Retiree Dental Plan

Delta Dental logo
http://www.deltadentalins.com
(800) 932-0783

FCPS offers two dental plans administered by Delta Dental.  One is a Standard plan with an annual limit of $1000 per person per plan year and one is a buy-up option plan with an annual limit of $2000 per person per plan year. Your plan will run on a calendar year basis from January 1st through December 31st.

Delta Dental Plan Highlights

Dental Services

Standard Plan

Buy-Up Plan

 

PPO – in-network

Out-of-Network

PPO – in-network

Out-of-Network

Deductibles

$0

$50 ind/$150 fmly

$0

$50 ind/$150 fmly

Diagnostic & Preventive

 

100%

 

100%

 

100%

 

100%

Basic Services

80%

80%

80%

80%

Major Services

50%

50%

50%

50%

 

Orthodontics Maximums

Unlimited Maximum

 $0 per person lifetime

deductible $2,000 per person

$50 per person lifetime deductible

Unlimited Maximum

 $0 per person lifetime

deductible $2,000 per person

$50 per person lifetime deductible

 

Maximum per person per Plan Year

 

$1,000 per person

 

$1,000 per person

 

$2,000 Per person

 

$2,000 per person

The above is intended for highlight information only.  Please refer to the detailed plan summary for the Standard Dental Plan or the Buy-up Dental Plan for exclusions and specific plan details. 

You can make changes to your Dental from standard plan to the buy-up plan during your open enrollment in October for January 1st by completing the Retiree Dental Buy Up Enrollment Form.

For more Detailed information please see the summary plan descriptions on the Retiree Dental Plan or the Retiree Dental Plan Buy-Up Option.