Your Dental Program

 

Introducing Spotlight for your employees
 
   Maximize your benefits. Register for Spotlight!
 
Your Dental Programs

We want to take this opportunity to welcome you to Delta Dental. We are the oldest, largest and leading dental benefits carrier in the nation and we look forward to exceeding your oral health needs in the years to come.

Delta Dental is pleased to provide dental benefits for employees of Bartlesville Chamber of Commerce. This website provides a brief description of the most important features of your Bartlesville Chamber of Commerce dental benefits. For more specific questions regarding your benefits, please contact our friendly Customer Service Department at 800-522-0188 (Toll Free) or 405-607-2100 (OKC Metro).

Under your Bartlesville Chamber of Commerce dental benefits program, there are two dental plan options available, Delta Dental PPO and Delta Dental PPO – Plus Premier.

Both Plans Feature:
  • Access to both the PPO and Premier network
  • Provider reimbursements based on network utilized
  • Additional out-of-pocket savings when utilizing a PPO network provider
  • No balance-billing for either network
  • Pre-existing conditions covered
  • Claim filing by participating dentist
Option 1: Delta Dental PPO

Click Here for a Detailed Benefit Summary

 

 
BENEFIT PLAN
Delta Dental PPO Delta Dental Premier Out of Network
 
Diagnostic & Preventive-Class I 100% 100% 100%
Basic Restorative-Class II 80% 80% 80%
Major Restorative-Class III 50% 50% 50%
Orthodontic - Class IV 50% 50% 50%
 
Deductible: $50 Per Person
Per Benefit Year
(Maximum $150
Per Family)
$50 Per Person
Per Benefit Year
(Maximum $150
Per Family)
$50 Per Person
Per Benefit Year
(Maximum $150
Per Family)
Applies to: Classes II & III Classes II & III Classes II & III
 
Maximum Benefit Payment: $1,500 Per Person Per Benefit Year for Class I, Class II, and Class III Services.
$1,000 Lifetime Maximum Per Dependent Child for Class IV Services.
 
         
 
Note:  Deductibles do not apply to Class I or Class IV services.
 
   
Option 2: Delta Dental PPO – Plus Premier

Click Here for a Detailed Benefit Summary
 
 
BENEFIT PLAN
Delta Dental PPO Delta Dental Premier Out of Network
 
Diagnostic & Preventive-Class I 100% 100% 100%
Basic Restorative-Class II 80% 80% 80%
Major Restorative-Class III 50% 50% 50%
Orthodontic - Class IV 50% 50% 50%
 
Deductible: $50 Per Person
Per Benefit Year
(Maximum $150
Per Family)
$50 Per Person
Per Benefit Year
(Maximum $150
Per Family)
$50 Per Person
Per Benefit Year
(Maximum $150
Per Family)
Applies to: Classes II & III Classes II & III Classes II & III
 
Maximum Benefit Payment: $1,500 Per Person Per Benefit Year for Class I, Class II, and Class III Services.
$1,000 Lifetime Maximum Per Dependent Child for Class IV Services.
 
         
 
Notes:  Deductibles do not apply to Class I or Class IV services.
 
 

The information contained herein is not intended as a Summary Plan Description, nor is it designed to serve as Evidence of Coverage for this program. Benefits for some covered services may be subject to waiting periods or limitations such as age of patient, frequency of procedure, etc., or excluded in some instances. If you have specific questions about your dental benefits, consult your Summary Plan Description, or call 405-607-2100 (OKC Metro) or 800-522-0188 (Toll Free). You may write Delta Dental of Oklahoma at P.O. Box 54709, Oklahoma City, Oklahoma 73154-1709.