Web Portal License. 1. Delta Dental grants to Contractor the License to access and use Delta Dental’s web portals solely for the purpose of administering and/or viewing Member Benefits as set forth in this Contract, subject to any additional terms and conditions appearing on such web portals. Under this license grant, Contractor’s Members are permitted to access and use Member Portal, and Contractor and its officers, directors, employees, contractors and agents are permitted to access and use Benefit Manager Toolkit as necessary solely for the purposes of administering Contractor’s dental plan.
Web Portal License. Delta Dental PPO™ (Point-of-Service) Summary of Dental Plan Benefits For Group# 10300-0001, 0099 Board of County Commissioners, Xxxxx County, Ohio Control Plan Delta Dental PPO™ Dentist Delta Dental Premier® Dentist Nonparticipating Dentist Plan Pays Plan Pays Plan Pays* Diagnostic & Preventive Diagnostic and Preventive Services 100% 100% 100% Sealants 100% 100% 100% Radiographs 100% 100% 100% Basic Services Emergency Palliative Treatment 80% 80% 80% Brush Biopsy 80% 80% 80% Minor Restorative Services 80% 80% 80% Endodontic Services 80% 80% 80% Periodontic Services 80% 80% 80% Oral Surgery Services 80% 80% 80% Other Basic Services 80% 80% 80% Relines and Repairs 80% 80% 80% Major Services Occlusal Guards/Adjustments 70% 70% 70% Major Restorative Services 70% 70% 70% Prosthodontic Services 70% 70% 70% Orthodontic Services Orthodontic Services 80% 80% 80% Orthodontic Age Limit through age 18 and under through age 18 and under through age 18 and under Benefit Year Covered Services ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ ⮚ Maximum Payment Payment for Orthodontic Service Deductible Waiting Period Eligible People Coordination of Benefits Delta Dental PPOTM Our national PPO program Welcome! Your dental program is administered by Delta Dental Plan of Ohio, Inc., a nonprofit health-insuring corporation, doing business as Delta Dental of Ohio. Delta Dental of Ohio is the state’s dental benefits specialist. Good oral health is a vital part of good general health, and your Delta Dental program is designed to promote regular dental visits. We encourage you to take advantage of this program by calling your Dentist today for an appointment. This Certificate, along with your Summary of Dental Plan Benefits, describes the specific benefits of your Delta Dental program and how to use them. If you have any questions about this program, please call our Customer Service department at 000-000-0000 or access our website at xxx.XxxxxXxxxxxXX.xxx. You can easily verify your own Benefit, Claims and eligibility information online 24 hours a day, seven days a week by visiting xxx.XxxxxXxxxxxXX.xxx and selecting the link for our Consumer Toolkit®. The Consumer Toolkit will also allow you to print claim forms and ID cards, select paperless Explanation of Benefits statements (EOBs), search our Dentist directories, and read oral health tips. We look forward to serving you! TABLE OF CONTENTS I. Delta Dental PPO Certificate 2 II. Definitions 2 III. Enrolling in This Plan 4 IV. Selecting a De...
