Benefits Summaries & Orientation

Dental


The Personalized Benefits Program offers two dental options. They are Delta Dental PPO (Point-of Service) and a "No Coverage" option for persons who prefer to use another non-GVSU dental plan. The Delta Dental PPO plan is administered by Delta Dental. This dental plan provides periodic coverage for the following services:

  • Preventive: Cleanings, exams, and 6 month x-rays. Fluoride treatments are covered for participants up to age 19.
  • Restorative: Fillings, root canals, crowns, x-rays, gum disease services, oral surgery, denture repair, and other restorative services
  • Orthodontic: Correction of poorly positioned teeth for any eligible person.

Delta Dental PPO (Point-of-Service)

 The Delta Dental PPO plan features a managed care incentive. The level of benefit coverage for eligible services depends on the dentist who is providing service(s). Under the Delta Dental PPO plan, you have a choice with every visit to use a Delta Dental participating dentist and receive the Premier level of benefit coverage or a Delta Dental PPO (PPO) member dentist and receive the PPO level of benefit coverage. The Delta Dental PPO plan provides an economic incentive to go to a PPO member dentist. You are free to change dentists at any time for any reason.

Participating dentists are reimbursed for each covered service performed based on the fee they charge for that service. PPO member dentists are paid on a fee-for-service basis according to a schedule established by Delta Dental.

The table below illustrates the different level of benefits and the percentages paid by Delta Dental and your co-pay percentage. Remember, in order to receive the PPO benefit, you must go to a PPO member dentist. Otherwise, your eligible services will be paid according to the Premier Dental benefit.

Get the Delta Certificate of Coverage Get the Delta Dental Benefit Summary Visit the Delta Dental website.  You can verify eligibility and benefits for yourself as well as spouses and dependents, check the status on claims, print an ID card, print a claim form and have access to a dentist directory - all through the consumer toolkit.

No Coverage

If you have dental coverage through a non-GVSU plan, you may choose the No Coverage option, which enables you to opt out of the GVSU dental plan. To be eligible for the No Coverage option, you must provide proof of coverage under another plan by completing the "Verification of Other Coverage - Dental" during enrollment. If you and your spouse are employed by GVSU, you both must choose a dental plan. You may not select the No Coverage option. However, you may list each other as dependents if you select dual or family coverage.

Faculty and staff who select the No Coverage option will receive a cash credit annually, to be used to purchase other benefits or to be added to their paychecks as taxable income. If you become ineligible for other dental coverage during the year because of a status change as defined under the Plan Document, you may enroll in this dental option.

 

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