SouthComm Communication Benefit Summary 2017

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Our dental plan offered through Delta Dental of Tennessee. As a member of Delta Dental you have access
to two different networks, the PPO Network or Premier Network. As long as your dentist participates in either
network, then you will receive in-network benefits and cannot be balance billed. Your benefits do go farther
using a PPO Dentist.
Delta Dental Mobile App
 Mobile Member ID Card
 View Claims and Check Network Providers
 Download through ITunes or Google Play by
Searching “Delta Dental”
Delta Dental Online Access
 Download ID card
 View claims, benefits, and find a provider
 Register at
In-Network Benefits PPO or Premier Network
Preventive Services:
 2 in 12 month period
 Cleanings and X-rays
Plan pays 100%
Basic Services: (fillings/root canals)
 Minor Restorative
 Basic and Major Endodontics
 Basic and Major Periodontics
 Basic and Major Oral Surgery
Plan pays 80%
Major Services (crowns, bridges, dentures)
 Major Restorative, Implants, and
Prosthodontics
Plan pays 50%
Calendar Year Deductible (Basic and Major
Services Only)
$50 Per person to family max of $150
$50 Per person to family max of $150
Calendar Year Maximum for Preventive/Basic/
and Major Services
$1,500 per covered person
Orthodontics for Dependent Children to Age 19 50% to Lifetime Maximum of $1,500 per covered
child
Dental Insurance
800-223-3104