Active Employees and COBRA Members

Northeast Delta Dental Customer Service 1-800-832-5700
www.nedelta.com

Plan Documents and Coverage

Plan Document (PDF) - A detailed description of the plan's coverage. Your right to appeal is outlined in this document (see "Disputed Claims Procedure"). 

Summary of Benefits Coverage (PDF) 

Outline of Benefits (PDF)

Health through Oral Wellness ("HOW") Program

Double-Up Max℠ Carryover Benefit

Premium Rates

For Active Employees and Covered Dependents Effective July 1, 2024 - June 30, 2025

Level of Coverage Biweekly Deduction for Full-Time Employees Biweekly State Contribution Monthly COBRA Rates (e.g. former employees)
Employee Only $0 $14.92 $30.44
Employee + 1 $11.76 $14.92 $54.43
Employee + 2 or More People $36.12 $14.92 $104.12

For Active Employees and Covered Dependents Effective July 1, 2023 - June 30, 2024

Level of Coverage Biweekly Deduction for Full-Time Employees Biweekly State Contribution Monthly COBRA Rates (e.g. former employees)
Employee Only $0 $14.60 $29.78
Employee + 1 $11.50 $14.60 $53.24
Employee + 2 or More People $35.34 $14.60 $101.88

Employee deductions listed above are withheld on a pre-tax basis.  Premiums for a domestic partner and partner's child or children are withheld post-tax. For premium amounts for part-time employees, contact Employee Health & Wellness at 1-800-422-4503.