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Small Group PPO Benefit Summaries

(10-50)

Small Group Plan Headers_PPO

 
 

PPO 3
100/80/50 plan
with 4 maximum options









Calendar year maximum
 PPO/Premier
& OON
per enrollee

 

$1,000, $1,500,
$2,000
or $5,000

Deductible
PPO/Premier
& OON
per person/per family (excluding P&D)

$50/$150







PPO 5
100/100/60 plan
with 3 maximum options









Calendar year maximum
 PPO/Premier
& OON
per enrollee

$1,500, $2,000,
or $5,000

Deductible
PPO/Premier
& OON
per person/per family (excluding P&D)

$50/$150 or
$75/$225












PPO A
100/80/50 & 80/60/50 plans
with 3 maximum options









Calendar year maximum
 PPO/Premier
& OON
per enrollee

$1,500,/$1,000,
$2,000/$1,500 or
$3,000/$2,500

Deductible
PPO
per person/per family (excluding P&D)
Premier & OON
per person/per family (excluding P&D)




$50/$150




$75/$225

PPO C
100/100/60 & 100/80/50 plans
with 3 maximum options









Calendar year maximum
 PPO/Premier
& OON
per enrollee

$2,000, $2,500 or $3,000

Deductible
PPO
per person/per family (excluding P&D)
Premier & OON
per person/per family (excluding P&D)




$50/$150




$75/$225

 

Special Health Care Needs Benefit
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The Special Health Care Needs Benefit from Delta Dental: Helping to break down barriers to care by providing eligible covered members with an enhanced benefit

DeltaVision employee vision plans
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Combining Deltavision with your Delta Dental benefits provides you with the convenience and affordability of two excellent programs in a single package

Teledentistry Virtual Visits
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"Virtual Visits" service is provided by Teledentistry.com. This service is a covered benefit in most Delta Dental of New Jersey plans for currently enrolled members.

Delta Dental hearing savings program
See Benefit

We've partnered with Amplifon Hearing Health Care to offer members access to a NO-COST hearing savings program that brings members huge savings on hearing aids and services.