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)
Health through Oral Wellness ("HOW") Program
Double-Up Max℠ Carryover Benefit
Premium Rates
For Active Employees and Covered Dependents Effective July 1, 2020 - 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 |
Premium Rates: July 1, 2019 - June 30, 2020
| Level of Coverage | Biweekly Deduction for Full-Time Employees | Biweekly State Contribution | Monthly COBRA Rates (e.g. former employees) |
|---|---|---|---|
| Employee Only | $0 | $14.31 | $29.20 |
| Employee + 1 | $11.27 | $14.31 | $52.19 |
| Employee + 2 or More People | $34.64 | $14.31 | $99.86 |
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.