Dental Plan Options

The Northern California Plasterers Trust offers dental coverage to active participants. The Fund offers a DPO and DHMO plan, both with the Premier Access dental network.  The schedule of benefits for DPO and DHMO is as follows.

Network Premier Access – DPO In-Network
Calendar Year Deductible None
Coinsurance Preventive Services: 100%
Basic Services: 85%
Crowns & Prosthodontics: 80%
of usual, reasonable & customary charges
Maximum Benefits Paid per Calendar Year $1,750
Orthodontia (dependent children only) 50% coinsurance; $1,500 lifetime maximum
Out of network benefits differ.  Please contact Health Services & Benefit Administrators for details.

 

 

Network Premier Access DHMO
Calendar Year Deductible $0
Coinsurance Preventive Services: 100%
Basic Services: $0 – $75 co-pays
Major Services: $50 – $100 co-pays
Maximum Benefits Paid per Calendar Year None
Orthodontia (dependent children only) $250 co-pay for unspecified procedure
$1450 co-pay for treatment, $250 co-pay for retention
Dental benefits are not available to retired participants.