Dental Plan Options
The Northern California Plasterers Trust offers dental coverage to active participants. The Fund offers a DPO and DHMO plan, both with the Premier Access dental network. The schedule of benefits for DPO and DHMO is as follows.
Network | Premier Access – DPO In-Network | |
Calendar Year Deductible | None | |
Coinsurance | Preventive Services: 100% Basic Services: 85% Crowns & Prosthodontics: 80% of usual, reasonable & customary charges |
|
Maximum Benefits Paid per Calendar Year | $1,750 | |
Orthodontia (dependent children only) | 50% coinsurance; $1,500 lifetime maximum |
Out of network benefits differ. Please contact Health Services & Benefit Administrators for details.
Network | Premier Access DHMO | |
Calendar Year Deductible | $0 | |
Coinsurance | Preventive Services: 100% Basic Services: $0 – $75 co-pays Major Services: $50 – $100 co-pays |
|
Maximum Benefits Paid per Calendar Year | None | |
Orthodontia (dependent children only) | $250 co-pay for unspecified procedure $1450 co-pay for treatment, $250 co-pay for retention |
Dental benefits are not available to retired participants.