Dental – The Principia

Dental Plans

Principia offers two dental plans through Delta Dental that provide cost-effective options for your dental needs, from regular cleanings to braces. You can go to the dentist of your choice, but you’ll receive the greatest benefit if you select an in-network provider.

To locate a provider, visit www.DeltaDentalMO.com. Select Find a Provider, Find a Dentist, and then filter by the Delta Dental PPO network.

Dental Benefits

Dental Plan Highlights	Dental Low Plan	Dental High Plan
Dental Plan Highlights	Dental Low Plan	Dental High Plan
Plan Year Deductible Individual / Family	$50 / $150	$50 / $150
Plan Year Maximum Benefit Per covered individual	$1,000	$1,500
Preventive Care (Tier 1) 2 exams/cleanings per calendar year	100% Deductible waived Preventive services do not count toward annual benefit max	100% Deductible waived Preventive services do not count toward annual benefit max
Basic restorative care (Tier 2) Fillings, minor extractions	80%	90%
Major restorative care (Tier 3) Root canals, major extractions	50%	60%
Orthodontia Adult and Child	None	Covered at 50%, up to lifetime maximum of $2,000 per person
Out-of-Network Benefits Deductible Tier 1 Tier 2 Tier 3	$100 / $300 80% 70% 50%	$50 / $150 100% 80% 50%
Monthly Premiums
Employee	$24.14	$45.60
Employee + Child(ren)	$61.16	$97.14
Employee + Spouse	$48.76	$82.72
Family	$91.54	$139.22

Know what’s covered before you get dental care

Before you receive dental care, work with your dental provider to get a “predetermination of benefits” from Delta Dental. This ensures that you and your dental provider understand what costs will be covered by the Principia dental plan and what costs will be your responsibility.