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Dental Coverage

Dental Plan Options

The Clovis Unified School District offers two dental plans to it’s full time and eligible part time employees through  Delta Dental of California. Since the CUSD Benefits Plan offers a composite rate, there is not a difference in premium costs, but each plan offers a different level coverage.  Employees may choose the dental plan that best suits their needs based on their utilization. Below is a brief description of the benefit provisions under each plan.  For a full, comprehensive breakdown and comparison of the plans, see the link to the right of this page.  

A graphic with a tooth, a magnifying glass, and a profile icon, along with text about Delta Dental's website and contact information.

A white button with the text 'Delta Dental PPO Plan #6749' in maroon.

The Delta PPO Plan is a Preferred Provider Program.  The program provides the maximum benefit when you visit a PPO dentist.  PPO Dentists are Delta Dentists that have agreed to charge reduced fees for services to PPO patients with the potential to receive more from the patient's annual maximum allowable.  

A white button with the text 'Delta Dental Premier Plan #6516 (Managed Fee-for-Service Program)' in maroon.

Under this program, Delta pays 70% of the approved fees for covered diagnostic, preventive, basic, cast and crown benefits during the first year you are eligible. This percentage will increase 10% each year (to a maximum of 100%) for each enrollee, provided that person visits the dentist at least once during the year. If an enrollee does not use the program during a calendar year, the percentage remains at the level reached the previous year. If an enrollee becomes ineligible for benefits and later regains eligibility, the percentage will drop back to 70%.

A table comparing dental insurance plans from Delta Dental, showing coverage details for different procedures.

  • Although both programs cover many of the most commonly needed services, some services are not covered. If you are unsure whether a particular procedure is covered, or how much of it is paid for by your program, check with Delta before proceeding.
     
    The following are not covered by the programs:

    • Services for injuries or conditions covered under Workers’ Compensation or Employer’s Liability Laws.
    • Cosmetic surgery or dentistry or services to correct congenital malformation
    • Experimental procedures
    • Therapeutic drugs, premedication or pain relievers
    • Hospital costs or extra charges for hospital treatment
    • Anesthesia (except for general anesthesia for oral surgery)
    • Extra-oral grafts, implants, and implant removal
    • Treatment related to the temporomandibular joint (TMJ)
    • Orthodontic treatment

The preceding information is not intended for use as a summary plan description, nor is it designed to serve as an evidence of coverage for the programs.  To use your Delta Premier plan or your Delta PPO plan, just call the dental office of your choice and make an appointment. During your first appointment, give your dentist your group number and the primary enrollee’s social security number.  If you have specific questions regarding benefit structure, limitations or exclusions, consult the evidence of coverage or contact Delta Dental's Member Service Department toll free at 888-335-8227.

DELTA DENTAL PLAN OF CALIFORNIA
P.O. BOX 7736
SAN FRANCISCO, CA 94120