Post-65 Retiree Dental


delta dental

ICSO H&W participating organizations have the opportunity of offering robust dental coverage for retirees, aged 65 and older.

Delta Dental is one of the leading providers of dental benefits in the United States and offers the largest networks of dentists in the country. Delta Dental also delivers some of the most effective discounts for dental services in the industry, averaging 20% across all claims paid. Other benefit enhancements include a $2,000 annual dental benefit and Orthodontia coverage for all insureds, including adults.

Key Benefit Features
In-Network Out-of-Network**
Calendar Year Deductible* $50 per Individual
3 per Family Maximum
Deductible, or $150
$75 per Individual
3 per Family Maximum
Deductible, or $225
Preventive Services (includes oral exam, cleanings,
and x-rays)
Plan pays 100% Plan pays 100%
Basic Services (e.g., fillings) Plan pays 80%,
Employees pays 20%
Plan pays 80%,
Employee pays 20%
Major Services (e.g., crowns) Plan pays 50%,
Employee pays 50%
Plan pays 50%,
Employee pays 50%
Annual Benefit Maximum
(for a combination of all three levels of service)
$2,000 $2,000
Orthodontic Services (Adult and Child) 50% 50%
Orthodontic Deductible None None
Orthodontic Lifetime Maximum $1,500 $1,500

* Deductible applies only to Basic and Major Services
** These Out of Network benefit levels apply to all states BUT: LA, MS, MT, and TX. For these 4 states, the Out of Network percentages are equal to the In Network percentages; Reasonable and Customary charges still apply to the Out of Network services performed.

PLEASE NOTE: If a conflict occurs between information in this table and the official plan documents that define these programs, the plan documents will govern.