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Welcome to Delta Dental of Oregon

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Welcome to Delta Dental of Oregon

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Summaries of benefits (SOB)s for small group plans Oregon


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View comparison chart of all small group dental plans

 


 

2020 Oregon small group dental plans (1-50)

Amounts are what members pay (in-network per person for ages 19+)

Plan Deductible Annual Max Exams and cleanings
Premier Plans
Delta Dental Premier®, 1000, 100*/80/50, 25 $25 $1,000 0%
Delta Dental Premier®, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental Premier®, 1000, 80/80/50, 50 $50 $1,000 20% after deductible
Delta Dental Premier®, 1500, 100*/80/50, 25 $25 $1,500 0%
Delta Dental Premier®, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental Premier®, 2000, 100*/80/50, 50 $50 $2,000 0%
Delta Dental Premier® Shining Smiles $50 N/A Not covered
Premier Preventative First Plans
Delta Dental Premier® PF, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental Premier® PF, 1500, 100*/80/50, 50 $50 $1,500 0%
Premier Voluntary Plans
Delta Dental Premier®, Voluntary, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental Premier®, Voluntary, 1000, 80/80/50, 50 $50 $1,000 20% after deductible
Delta Dental Premier®, Voluntary, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental Premier®, Voluntary, 1500, 80/80/50, 50 $50 $1,500 20% after deductible
PPO Plans
Delta Dental PPOSM, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, 1000A, 100*/90/50, 50 $50 $1,000 0%
Delta Dental PPOSM, 1000B, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental PPOSM, 1500A, 100*/90/50, 25 $25 $1,500 0%
Delta Dental PPOSM, 1500A, 100*/90/50, 50 $50 $1,500 0%
Delta Dental PPOSM, 1500B, 100*/80/50, 25 $25 $1,500 0%
Delta Dental PPOSM, 1500B, 100*/80/50, 50 $50 $1,500 0%
Delta Dental PPOSM, 2000B, 100*/80/50, 50 $50 $2,000 0%
PPO Preventive First Plans
Delta Dental PPOSM, PF, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, PF, 1000A, 100*/90/50, 50 $50 $1,000 0%
Delta Dental PPOSM, PF, 1000B, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, PF, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental PPOSM, PF, 1500A, 100*/90/50, 50 $50 $1,500 0%
Delta Dental PPOSM, PF, 1500B, 100*/80/50, 50 $50 $1,500 0%
PPO Voluntary Plans
Delta Dental PPOSM, Voluntary, 1000, 100*/90/50, 50 $50 $1,000 0%
Delta Dental PPOSM, Voluntary, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, Voluntary, 1500, 100*/90/50, 50 $50 $1,500 0%
Delta Dental PPOSM, Voluntary, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental EPO Plans
Delta Dental EPO,1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental EPO,1500, 100*/80/50, 50 $50 $1,500 0%
* Deductible waived for Class 1 services
PF means Class 1 does not apply to annual maximum

 

2019 Oregon small group dental plans (1-50)

Amounts are what members pay (in-network per person for ages 19+)

 

2019 OREGON
Plan Deductible Annual Max Exams and cleanings
Premier Plans
Delta Dental Premier®, 1000, 100*/80/50, 25 $25 $1,000 0%
Delta Dental Premier®, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental Premier®, 1000, 80/80/50, 50 $50 $1,000 20% after deductible
Delta Dental Premier®, 1500, 100*/80/50, 25 $25 $1,500 0%
Delta Dental Premier®, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental Premier®, 2000, 100*/80/50, 25 $25 $2,000 0%
Delta Dental Premier®, 2000, 100*/80/50, 50 $50 $2,000 0%
Delta Dental Premier® Shining Smiles $50 N/A Not covered
Premier Preventative First Plans
Delta Dental Premier® PF, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental Premier® PF, 1500, 100*/80/50, 50 $50 $1,500 0%
Premier Voluntary Plans
Delta Dental Premier®, Voluntary, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental Premier®, Voluntary, 1000, 80/80/50, 50 $50 $1,000 20% after deductible
Delta Dental Premier®, Voluntary, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental Premier®, Voluntary, 1500, 80/80/50, 50 $50 $1,500 20% after deductible
PPO Plans
Delta Dental PPOSM, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, 1000A, 100*/90/50, 50 $50 $1,000 0%
Delta Dental PPOSM, 1000B, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental PPOSM, 1500A, 100*/90/50, 25 $25 $1,500 0%
Delta Dental PPOSM, 1500A, 100*/90/50, 50 $50 $1,500 0%
Delta Dental PPOSM, 1500B, 100*/80/50, 25 $25 $1,500 0%
Delta Dental PPOSM, 1500B, 100*/80/50, 50 $50 $1,500 0%
Delta Dental PPOSM, 2000, 100*/80/50, 50 $50 $2,000 0%
Delta Dental PPOSM, 2000A, 100*/90/50, 25 $25 $2,000 0%
Delta Dental PPOSM, 2000A, 100*/90/50, 50 $50 $2,000 0%
Delta Dental PPOSM, 2000B, 100*/80/50, 25 $25 $2,000 0%
Delta Dental PPOSM, 2000B, 100*/80/50, 50 $50 $2,000 0%
PPO Preventive First Plans
Delta Dental PPOSM, PF, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, PF, 1000A, 100*/90/50, 50 $50 $1,000 0%
Delta Dental PPOSM, PF, 1000B, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, PF, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental PPOSM, PF, 1500A, 100*/90/50, 50 $50 $1,500 0%
Delta Dental PPOSM, PF, 1500B, 100*/80/50, 50 $50 $1,500 0%
PPO Voluntary Plans
Delta Dental PPOSM, Voluntary, 1000, 100*/90/50, 50 $50 $1,000 0%
Delta Dental PPOSM, Voluntary, 1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental PPOSM, Voluntary, 1500, 100*/90/50, 50 $50 $1,500 0%
Delta Dental PPOSM, Voluntary, 1500, 100*/80/50, 50 $50 $1,500 0%
Delta Dental EPO Plans
Delta Dental EPO,1000, 100*/80/50, 50 $50 $1,000 0%
Delta Dental EPO,1500, 100*/80/50, 50 $50 $1,500 0%
* Deductible waived for Class 1 services

PF means Class 1 does not apply to annual maximum

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