Dental

Delta Dental of Kansas

www.deltadentalks.com
1-800-234-3375

Who is Eligible and When

Active associates working a minimum of 30 hours per week, their spouse and dependent children are all eligible for coverage. Qualified Associates have up to 30 days to enroll in the plan after they become benefit eligible. Most benefit changes require a “qualifying life event” and must be identified within 30 days. Failure to do so will disqualify you from changing coverage until the next open enrollment.

Coverage in the dental plan is effective the first of the month coincident or next following the date of hire. Coverage terminates on the last day of the month coincident or next following the date in which an associate no longer meets the criteria for eligibility.

Delta Dental of Kansas provides a national network. Refer to www.deltadentalks.com for a listing of in-network providers.

Type of Service

Premier/PPO/Non-Participating Network Coverage

Deductible

$50 per person
$150 per family

Annual Maximum

$1,000 per participant

Preventive Services

100%

Basic Services

80%

Major Services

80%

Orthodontia (coverage is exclusive to dependent children under age 19)

50% ($1,000 lifetime maximum)

Complete information on dental benefits can be found in the Mariner Holdings, LLC Health Care Plan Summary Plan Description and SPD Supplement on the Annual Notices Page.