Dental

 

(Optional)

The Dental Benefit is administrered by Deltal Dental: 1-866-579-5717, www.deltadentalins.com/mus

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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