Englewood Schools

Belong and Thrive

 

 2017
DENTAL
 
Delta Dental Benefit Summary:
$50 Individual/$150 Family Deductible
Annual Max: $2000
Preventative & Diagnostic: 100% Covered for PPO / 80% for Premier
Basic Services: 80% for PPO / 80% for Premier
Major Services: 50% for PPO / 50% for Premier
Orthodontic Services: 50% for PPO / 50% for Premier
 

DELTA DENTAL MONTHLY PREMIUMS
Employee: $17.94*
Employee + 1: $47.64
Employee + Family: $87.97
*Rates Above Reflect 50% District Contribution for Employee
 

COBRA GENERAL NOTICE

 Please find the link to the Required COBRA General Notice for all individuals enrolled in Kaiser, Delta or VSP below:
 
 
 

DELTA DENTAL ENROLLMENT OR CHANGE OF STATUS FORM

DELTA DENTAL PLAN INFORMATION

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