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| Northeast Delta Dental |
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Bi-weekly Cost: |
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Basic |
Core |
Plus |
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Employee Only |
$8.57 |
$11.82 |
$15.21 |
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Employee & Children |
$20.90 |
$24.33 |
$37.80 |
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Employee & Spouse |
$16.03 |
$22.12 |
$28.45 |
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Family |
$30.68 |
$37.38 |
$53.00 |
Plan Hightlights
| Basic |
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Preventive Care
Plan pays 100%
You pay 0%
Basic Restorative Care
Plan pays 60%
You pay 40%
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Major Restorative
Not covered
Orthodontia
Not covered
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Annual Maximum
$1,000
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| Core |
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Preventive Care
Plan pays 100%
You pay 0%
Basic Restorative Care
Plan pays 60%
You pay 40%
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Major Restorative
Plan pays 50%
You pay 50%
Orthodontia
Not covered |
Annual Maximum
$1,000
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| Plus |
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Preventive Care
Plan pays 100%
You pay 0%
Basic Restorative Care
Plan pays 80%
You pay 20% |
Major Restorative
Plan pays 50%
You pay 50%
Orthodontia
Plan pays 50%
You pay 50%
$100 deductable
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Annual Maximum
$1,500
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July 23, 2008
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Eastern Maine Healthcare
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