Retiree Dental Plan

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

FCPS offers two dental plans administered by Delta Dental. Effective January 1, 2020, one is a standard plan with an annual limit of $1500 per person per plan year and one is a buy-up option plan with an annual limit of $2500 per person per plan year. Your plan will run on a calendar year basis from January 1st through December 31st.

Delta Dental Plan Highlights - Effective January 1, 2020

Dental Services

Standard Plan
PPO – in-network

Standard Plan
Out-of-Network

Buy-Up Plan
PPO – in-network

Buy-Up Plan
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

 

$1,500 per person

 

$1,500 per person

 

$2,500 Per person

 

$2,500 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.