CINER 2018 Benefit Guide

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UND ER S TAND I NG
YOUR DENTAL PLAN
Ciner offers a comprehensive dental plan through Delta
Dental. You can elect dental coverage even if you don’t
elect medical coverage through Ciner.
The plan permits you to use both in-network and out-of-
network providers. There are two networks to select
from: the Premier and the PPO network. The PPO
network providers offer larger discounts and providers in
both networks can file your claims for you. If you prefer
to see an out-of-network provider, keep in mind, because
they are not contracted to accept the negotiated
discounted rate, they may charge you for any amount
billed in excess of the negotiated discounted rate.
To determine if your dentist is in the network, visit
enter your search criteria (location,
name, etc.) and select either the Delta Dental PPO or
Premier network under the “Find a Dentist” heading.
For specific dental services not identified below or for
frequency limitations that may apply, please refer to your
Summary of Benefits.
Dental Questions? Need to Locate a Provider?
Contact Delta Dental (Group # 6094)
800-521-2651 or
Delta Dental PPO Plan
Deductible (waived for preventive care)
Employee Only $50
Employee plus dependent(s) $100
Calendar Year Maximum $1,500
Type of Dental Service
Preventive Services
-Initial oral exams -Space maintainers
-Periodic oral exams -X-rays
-Prophylaxis (cleanings) -Sealants
-Topical Application of Fluoride
Covered at 100%*;
not subject to Calendar Year Maximum
Basic Restorative Services
-Fillings -Oral surgery
-Endodontics -Re-cement crowns/bridge
-Extractions -Emergency treatment
-Repair of dentures -Relining of dentures
-Periodontic maintenance cleaning (2 annually)
Plan pays 80%*
after Deductible
Major Restorative Services
-Inlays -Post & Core
-Onlays -Prosthodontics
Plan pays 50%*
after Deductible
Orthodontic Services
50%* up to $1,500
lifetime maximum
per person
20
*Out-of-network services are reimbursed at the same benefit level up to the maximum allowable charge a network dentist would receive.