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American Chemistry Council 2017 Summary of Benefits
Dental
Insurance
Delta Dental
www.deltadentalins.com800-932-0783
The Council offers dental insurance through Delta Dental. Your dental coverage is effective on the first
day of the month coincident with or following your date of hire.
In-Network
Out of Network
Deductible
$0.00
$50.00
Cleanings
2 per year @ 100%
2 per year @ 100%
Basic Services
90%
80%
Major Services
60%
50%
Plan Year Maximum
$2,500
$2,500
Orthodontia is covered at 50% with a lifetime maximum of $2,500. This benefit is provided to both children
and adults. These pre-tax deductions are withheld from your paycheck on a bi-weekly basis.
Plan Options
Per Pay Period Deductions
Employee Only
$9.90
Employee Plus Child(ren)
$19.81
Employee Plus Spouse
$19.81
Family
$19.81