Dental
PLANS
Benefit Options offers two dental plan options.
UHC SOLSTICE S800B DHMO
- A Dental Health Maintenance Organization Plan (DHMO) without deductibles or dollar limits.
- You must use an in-Network provider; out-of-network services are covered only in emergencies.
- Find a provider on smilestateofaz.com. Residents of these states and territories cannot enroll in the DHMO: AK, AL, AR, DE, HI, IA, ID, LA, ME, MS, MT, ND, NE, NH, OK, RI, SD, VT, WV, WY, GU, USVI, and PR.
- UHC Solstice S800B Enrollment Booklet with Schedule of Benefits
- Please note: this replaces the previous DHMO called Cigna Dental Care Access.
DELTA DENTAL PPO PLUS PREMIER
- A Dental Preferred Provider Organization Plan.
- Services can be obtained in-Network or out-of-Network but will have higher costs for out-of-Network services.
- Additionally, there are in-Network and out-of-Network deductibles that must be met.
ID Cards
- When you enroll in dental benefits, you will receive a dental ID card within a few weeks. You can also access your ID card via the insurance company’s website or app. Contact your carrier if you need assistance before you can retrieve your card information. See the information below.
POLICIES | SUMMARY PLAN DESCRIPTIONS - SPD
PREMIUMS & COPAYS
| 2023 Dental Plan Premiums Per Pay Period | UHC SOLSTICE S800B DHMO | Delta PPO Plus Premier |
|---|---|---|
| Employee Only | $1.64 | $14.30 |
| Employee + Adult | $3.29 | $30.33 |
| Employee + Child | $3.08 | $23.34 |
| Employee + Family | $5.46 | $48.26 |
CONTACT
UHC Solstice | 844-208-0223 | smilestateofaz.com | Group: S800B
Delta Dental of Arizona | 602-588-3620 | 866-978-2839 | deltadentalaz.com | Group: 77777-0000
