If you enroll in State Group Health (SGH) Insurance, you may elect the Uniform Dental Benefit (UDB) for routine preventive and basic dental services. An additional cost will be added to your monthly health insurance premium. If you are not enrolled in SGH, you may elect the Preventive Dental plan to cover basic and preventive dental services.
Added to your health insurance premium
Employees working less than 50% should review premium costs
|$4 (Individual), $9 (Family)|
No out-of-network coverage
|Delta Dental PPO or Premier providers|
|Annual Benefit Max||$1,000 per person|
|Diagnostic and Preventive Services|
|Routine evaluations, dental cleanings, sealants, bitewing and panoramic X-rays, fluoride treatments||100%|
|Anesthesia (general and IV sedation)||80%|
|Emergency pain relief||80%|
|Crowns, bridges, dentures, implants||No coverage|
|Surgical extraction, root canal (endodontics), periodontics (except maintenance), oral surgery||No coverage|
|Coverage||50% (Under age 19)|
If you need additional coverage for major/restorative dental services or adult orthodontia, see the supplemental dental options.