| Carrier: | Delta Dental |
| Plan Type: | PPO |
| Group #: | 1778 |
| Customer Service: | 800-832-5700 |
| Provider Directory: | www.nedelta.com |
| Claims Address: | Northeast Delta Dental |
| PO Box 2002 | Concord, NH 03302 |
| PREVENTATIVE | 100% | Coverage A |
| BASIC | 80% | Coverage B (deductibles apply) |
| MAJOR | 50% | Coverage C (deductibles apply) |
| ORTHODONTICS | 50% | Coverage D |
Calendar Year Maximum: $1,000 per person (Coverages A, B, and C combined)
Orthodontics Maximum: $1,500 lifetime per person
*Benefit percentages shown are based upon the actual charge submitted to a maximum of the participating dentist's approved fees, or Delta Dental's allowance for nonparticipating dentists.
Available products expire on 12/31/2019. Please contact your recruiter or contact us at 800-995-2673 for additional information.
Additional services and coverage provided. For additional information, please contact us or email benefits@CoreMedicalGroup.com.
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