IMRF Endorsed Plans

Delta Dental of Illinois

• Available nationwide to all IMRF retirees and spouses of any age.
• Coverage includes preventative, basic and major dental services.
• Most significant savings seen if you go to a PPO DENTIST.
• DeltaPreferred Option network dentist, out-of-network dentist also covered. DeltaPreferred and DeltaPremier dentists will file claims for you.
• Open enrollment all year long. *
• No waiting period, one year enrollment required.
• $1,000.00 annual maximum.
  
  *New retirees and members meeting change of status requirements may enroll during the plan year.

2008 Premiums: Individual $24.81, Individual + Spouse $49.63, Family $77.31

Premiums	Individual	Individual + Spouse	Family
	$24.81	$49.63	$77.31

Benefit Level	Delta Preferred Option PPO Dentist	DeltaPremier Dentist	Out-of-Network Dentist
Diagnostic & Preventive	100% of discounted fees	100% of discounted fees	100% of discounted fees
Minor Restorative, Non-surgical Periodontics, Endodontics, Oral Surgery**	50% of discounted fees	50% of discounted fees	50% of discounted fees
Major Restorative, Sugical Periodontics, Prosthodontics	25% of discounted fees	25% of discounted fees	25% of discounted fees

**Minor and Major Restorative subject to one annual $50.00 deductible per person.

Benefit Levels

Diagnostic

• Routine exams twice a year
• Bitewing X-rays twice a year
• Full-mouth X-rays every three years

Preventive

• Cleanings twice a year
• Fluoride treatments for children once a year
• Space maintainers

Minor Restorative

• Amalgam and resin filings
• Sealants

Non-surgical Periodontics

• Treatment of gum disease

Endodontics

• Root canals and pulpal therapy

Oral Surgery

• Extractions and other oral surgery (including pre- and post-operative care)

Major Restorative

• Cast restorations; crowns, onlays, and other ceramic restorations to permanent teeth

Surgical Periodontics

• Prosthodonics
• Bridges, partial dentures and complete dentures
• Click here for Delta Dental Enrollment Forms.
  

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