Delta Dental

USF offers a dental PPO plan through Delta Dental of California, giving you the freedom to visit any in-network or out-of-network dentist you choose. You may be liable for higher out-of-pocket expenses if the dentist is not in the Delta Dental network.

This incentive plan rewards employees for going to the dentist at least once a year. During the first year, the Delta Dental plan pays 70%1 of the cost for many dental services up a maximum of $1,7502 per calendar year, per participant. This percentage will increase by 10% each year if you see a dentist at least once a year, until it reaches 100%. If you do not use the plan for a year, this percentage remains the same as the year before. If you and/or your Dependents lose your plan benefits and then get them back, the percentage will be reset to 70%.

Refer to the Benefits Compliance Documents web page for a summary of benefits and evidence of coverage.

IMPORTANT: Review the comparative costs of visiting an in-network dentist versus an out-of-network dentist.

1 Delta Dental out-of-network claims are reimbursed at the 80th percentile of the Usual, Customary and Reasonable (UCR) reimbursement rate. The incentive plan still applies.

2 Calendar year dental plan maximum is $1,500 for USFFA members per their Collective Bargaining Agreement (CBA).

The claim example below assumes that you have satisfied the incentive plan and your coverage is at 100% for the treatment received.

fee delta dental ppo dentist non-delta dentist
Example: Dentist charges for a crown $1,000 $1,000
Accepted Fee $600 $1,000
Reimbursement allowed by plan (Maximum Permitted Allowance, MAP) $600

$750

(example  MPA, not actual)
Reimbursement based on PPO fee

80th percentile of UCR*

Delta Dental plan pays
(100% of maximum plan allowance)

 $600 $750

Member pays
(Difference between “accepted fee” and “Delta Dental plan pays”)

 $0 $250
Plan savings $600 savings to member -$250 cost to member

*Percentiles are calculated by ranking a set of given fees in your area from lowest to highest. On a list of 10 given fees, the eighth ranked fee would be considered the 80th percentile.