The Dental Benefit is administrered by Deltal Dental: 1-866-579-5717,

Retirees are offered enrollment in the Premium Dental Plan only. If you do not make an election when you first retire, you will permanently forfeit your dental coverage eligibility unless a qualifying event occurs. Retirees must be qualified to enroll.


Premium Plan Coverage
Who May be Enrolled &
Monthly Rates
  • Employee Only $52
  • Employee & Spouse/Adult Dep. $94
  • Employee & Child(ren) $94
  • Employee & Family $156
Maximum Annual Benefit
$1,500 per covered individual
Preventive and Diagnostic Services
  • Twice Per Benefit Year
  • Initial and Periodic oral exam
  • Cleaning
  • Complete series of intraoral X-rays

The Preventive & Diagnostic Services listed above do not apply to the $1,500 annual maximum

Basic Restorative Services
  • Amalgam filling
  • Endodontic treatment
  • Periodontic treatment
  • Oral surgery
Major Dental Services
  • Crown
  • Root canal
  • Complete lower and upper denture
  • Dental implant
  • Occlusal guards
Removal of impacted teeth
  • Covered benefit


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