Embedded Files
Rates:
Family - $9.03 / pay deduction
Single - $3.50 / pay deduction
Dental Summary 07.2025.pdfOverview of Coverage
Finding and Choosing a Network Provider.pdfFinding a Provider
MaximizeBenefits_OnlineAccount_SS307-2210-web.pdfRegister for Online Account
SPD 07.2025.pdfPlan Summary
CheckUpPlus.pdfCheckUp Plus
EBICP Info.pdfEvidence Based Integrated Care Plan (EBICP)
EBICP Enrollment.pdfEvidence Based Integrated Care Plan (EBICP) - Enrollment
Special Health Care Needs Benefit.pdfSpecial Health Care Needs Benefit
Enrollment-Change-Waiver Form - Dental and Vision.pdfChange Form (Qualifying Event)
doc00234620191003084542.pdfNondiscrimination & Accessibility Requirements
Delta Dental Mobile Features (1).pdfDelta Dental Mobile Features
Predetermination of Benefits (1).pdfPredetermination of Benefits
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