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2019 Retiree Dental Plan Premiums

​The premiums shown below are effective January 1, 2019.

State-Sponsored  Dental Plans

 Prepaid Dental Plans 

Prepaid Dental Plans
​Level of Coverage ​DeltaCare USA Premier Access​ SafeGuard Enhanced​ Western Dental​

​Party Code 1

​$19.44

​$15.80

​$16.06

​$15.77

​Party Code 2

​$31.90

​$25.59

​$27.18

​$26.02

​Party Code 3

​$44.13

​$35.84

​$33.48

​$36.91

 

Delta Dental PPO plus Premier Basic Plan

Delta Dental PPO plus Premier Basic Plan
​Level of Coverage ​State Share ​Retiree Share ​Total Premium

​Party Code 1

​$38.12

​$12.71

​$50.83

​Party Code 2

​$66.56

​$22.19

​$88.75

​Party Code 3

​$96.21

​$32.07

​$128.28

  

Delta Dental Preferred Provider Plan (PPO)

Delta Dental Preferred Provider Plan (PPO)
​Level of Coverage ​State Share ​Retiree Share ​Total Premium

​Party Code 1

​$34.84

​$11.61

​$46.45

​Party Code 2

​$67.73

​$22.58

​$90.31

​Party Code 3

​$101.91

​$33.97

​$135.88

 

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