California HMO Plans
Plan Details
We offer an individual or voluntary dental plan through DeltaCare PMI.
With DeltaCare, you select one conveniently located network dentist to provide dental care for you and your family. You pay a small copayment or, for some services, no copayment. There are no deductibles or maximums and virtually no claim forms to worry about.
About DeltaCare
PMI offers a dental HMO program, DeltaCare, to take care of the dental care needs for you and your family. The DeltaCare program focuses on preventing dental problems and assuring the delivery of quality dental care.
PMI has contracted with a network of dental offices. Please follow this link to search for DeltaCare Providers. As an enrollee in the DeltaCare program, you select one office for your entire family's needs. PMI's network of dental offices is composed of established dental practices.
Who Can Join
As a California resident, you are eligible to join the Small Business Benefit Plan Trust, Wolfpack Insurance Services DeltaCare program.
Your eligible dependents include your lawful spouse and unmarried children under 19 years old (up to 23 if a full time student), including stepchildren and children placed with you for adoption or foster care. An unmarried child 19 years of age or older may continue to be eligible as a dependent if incapable of self-support because of physical handicap or mental retardation that commenced prior to age 19, provided that the person is legally residing with and dependent upon the eligible member, and PMI received notice of the disability.
No Claim Forms
The dental location you choose provides all primary dental services. There are no claim forms to complete or percentage of usual charges for you to pay.
No Deductibles
With the DeltaCare program, there are no required deductibles so pay, so your benefits begin immediately.
No Dollar Limit of Dental Benefits
No annual maximum
No Pre-Existing Condition Restrictions
Pre-existing conditions are not excluded in the DeltaCare program. Exception: work in progress.
Prepaid Program Saves on Dental Costs
Your out-of-pocket savings could be substantial. You know the exact cost prior to treatment, allowing you to predict future dental expenses.
When you enroll in this program, you are enrolling for a period of one year. This does not apply if your employment is terminated.
Emergency Services
Out-of-area dental emergencies are covered up to a maximum of $100.00. "Out -of-area' means 35 miles of more from your PMI participating dentist's office.
Quality Review of Dental Providers
On-site audits of participating dental locations ensure that established standards of quality are maintained.
Specialty Services
The DeltaCare program offers services in dental specialty areas. These include periodontics (treatment of diseased gums and bone), endodontics (root canal therapy) and oral surgery procedures. If an enrollee is assigned to a dental school clinic for specialist services, those services may be provided by a dentist, a dental instructor a clinician or a dental student under the supervision of a dentist.
The DeltaCare program provides all reasonable and customary dental care (subject to the provisions, limitations and exclusions and governing administrative policies shown in the Combined Evidence of Coverage and Disclosure Form) if care is provided by your assigned PMI network dentist.
When you enroll in DeltaCare, Please follow this link to search for DeltaCare Providers and select a DeltaCare Provider to take care of the dental needs for you and your family. After you have enrolled, you will receive a Combined Evidence of Coverage and Disclosure Form that fully describes the benefits of your dental program, and a DeltaCare membership card. This card will have the address and telephone number of your participating network dentist. To receive all necessary dental care covered by the program, simply call you selected dental office to make an appointment.
Remember to always contact your network dentist. Dental services which are not performed by this dentist or are not authorized in advance by PMI will not be covered under the DeltaCare program.