Dental Coverage

Dental Plan Options

The Clovis Unified School District offers two dental plans to it’s full time and eligible part time employees through Delta Dental of California. Since the CUSD Benefits Plan offers a composite rate, there is not a difference in premium costs, but each plan offers a different level coverage. Employees may choose the dental plan that best suits their needs based on their utilization. Below is a brief description of the benefit provisions under each plan. For a full, comprehensive breakdown and comparison of the plans, see the link to the right of this page.

For questions about your dental coverage please contact Delta Dental at 866-499-3001.

Delta Premier Plan #6516

Delta Premier Plan #6516 Managed Fee-For-Service Program

Under this program, Delta pays 70% of the approved fees for covered diagnostic, preventive, basic, cast and crown benefits during the first year you are eligible. This percentage will increase 10% each year (to a maximum of 100%) for each enrollee, provided that person visits the dentist at least once during the year. If an enrollee does not use the program during a calendar year, the percentage remains at the level reached the previous year. If an enrollee becomes ineligible for benefits and later regains eligibility, the percentage will drop back to 70%.

Delta PPO Plan #6749

The Delta PPO Plan is a Preferred Provider Program. The program provides the maximum benefit when you visit a PPO dentist. PPO Dentists are Delta Dentists that have agreed to charge reduced fees for services to PPO patients with the potential to receive more from the patient's annual maximum allowable.

Services Not Covered

Although both programs cover many of the most commonly needed services, some services are not covered. If you are unsure whether a particular procedure is covered, or how much of it is paid for by your program, check with Delta before proceeding.

The following are not covered by the programs:

Services for injuries or conditions covered under Workers’ Compensation or Employer’s Liability Laws.
Cosmetic surgery or dentistry or services to correct congenital malformation
Experimental procedures
Therapeutic drugs, premedication or pain relievers
Hospital costs or extra charges for hospital treatment
Anesthesia (except for general anesthesia for oral surgery)
Extra-oral grafts, implants, and implant removal
Treatment related to the temporomandibular joint (TMJ)
Orthodontic treatment

THE PRECEDING INFORMATION IS NOT INTENDED FOR USE AS A SUMMARY PLAN DESCRIPTION, NOR IS IT DESIGNED TO SERVE AS AN EVIDENCE OF COVERAGE FOR THE PROGRAMS. BOTH THE DELTA PREMIER PLAN AND THE PPO PLAN ARE EASY TO USE

To use your Delta Premier plan or your Delta PPO plan, just call the dental office of your choice and make an appointment. During your first appointment, give your dentist your group number and the primary enrollee’s social security number.

Your benefits administrator has a complete list of Delta Premier and Delta PPO network dental offices and Delta dentists, or you may call (800) 4-AREA-DR (800-427-3237) to obtain a list of participating dentists in your area. You may also search our online directory via our web site at www.deltadentalca.org.

THE DELTA PREMIER PROGRAM AND THE DELTA PPO PROGRAM ARE ADMINISTERED BY DELTA DENTAL PLAN OF CALIFORNIA. IF YOU HAVE SPECIFIC QUESTIONS REGARDING BENEFIT STRUCTURE, LIMITATIONS OR EXCLUSIONS, CONSULT THE EVIDENCE OF COVERAGE OR CONTACT DELTA’S CUSTOMER AND MEMBER SERVICE DEPARTMENT

DELTA DENTAL PLAN OF CALIFORNIA
P.O. BOX 7736
SAN FRANCISCO, CA 94120

For claims, eligibility and benefit inquiries, call Delta’s Customer and Member Service Department toll free at (888) 335-8227