UAW Local 1268

DELTA DENTAL BENEFITS OVERVIEW

Maximum – Actives ($1,850.00) per year (Jan. thru Dec.) for each person on your Dental plan.

Cleanings – 2 per year

If there is documented history of periodontal disease 3 cleanings will be allowed.

Dental X-Rays – Full mouth x-rays, once every 5 years.

Bitewing x-rays – Age 15 and older every 2 years (changed from once a year).

Age 14 and younger once a year.

Orthodontics – (Up to age 19) Covered at 50% up to lifetime maximum.

Actives – Lifetime maximum of $2,200.00

Providers – Always make sure the dentist is participating with Delta.  Even if you are

referred to another dentist it is your responsibility to make sure the dentist

is participating (they have a contract with Delta Dental).  Directories are

available in the UAW Benefits Office or you can call Delta 1-888-293-8271.

Delta Dental ID Number – Is your social security number

Group Number - 8220

NOTE:  JULY 1, 2009 RETIREES NO LONGER HAVE DENTAL OR VISION BENEFITS.

UAW BENEFITS OFFICE