Little River Casino & Resort 2017 Benefits Book

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Dental Plan
Little River Casino Resort offers Base and Buy-Up Plan options through Delta Dental of Michigan. Little River pays for 100% of the
cost of the Base Plan for employees and eligible dependents. Employees can elect to purchase a higher level of coverage under
the Buy-Up Plan (see premiums below). A brief summary of the coverage for these two plans is shown below. Please consult the
full plan summary for more detailed information.
It is important you see a provider in the Delta Dental of Michigan network to obtain the best coverage as you will pay a higher
amount if you see a non-network dentist. You can go to or call Delta Dental’s customer service number
on the Contacts page of this benefits guide to find an in-network provider.
Base Plan
Delta Dental of Michigan
PPO/Premier Network
Buy-Up Plan
Delta Dental of Michigan
PPO/Premier Network
In-Network Non-Network In-Network Non-Network
Annual Maximum $1,000 $1,000 $1,500 $1,500
Deductible $50/$150 $50/$150 $50/$150 $50/$150
Waived for Preventive Yes Yes Yes Yes
Preventive 100% 100% 100% 100%
Basic 50% 50% 80% 80%
Major 50% 50% 50% 50%
Patient is not responsible for
total billed charges
Paid at PPO allowed amount +
balance billed up to what non-
network dentist charges
Patient is not responsible for
total billed charges
Paid at PPO allowed amount +
balance billed up to what non-
network dentist charges
Orthodontia – Adult & Child
Deductible
Maximum
No Coverage
No Coverage
No Deductible, Covered at 50%
$1,500 lifetime maximum per enrolled member
Rates below are per pay period (26 pay periods per year)
Coverage Tier Base Plan Buy-Up Plan
Employee Only $0.00 $3.86
Employee + 1 $0.00 $7.47
Employee + Family $0.00 $16.44