| Resources |
Locke Lord offers its dental program through Delta Dental of Texas. The Delta Dental PPO plan provides comprehensive dental coverage, such as orthodontia and implants, and has a $3,500 annual maximum benefit. The Delta Dental PPO Plan allows you to see any dentist you want. However, if you select a dentist who participates in the Dental Provider Organization (DPO), you avoid any balance billing above the plan’s fee based schedule.
ABOUT YOUR DENTAL INSURANCE The Locke Lord dental plan covers the four main types of dental expenses:
- preventive and diagnostic care (routine exams and cleanings, fluoride treatments, sealants, full mouth x-rays, bitewing x-rays)
- basic treatment (pulling teeth, fillings, root canals, denture repair)
- major treatment (implants, crowns, bridges)
- orthodontia treatment
When you need dental care, you can choose to use one of the plan’s preferred dentists, or go to any other dentist of your choice. There are advantages to using the plan’s preferred dentists. Preferred dentists:
- will not charge more than the plan’s allowance for each procedure
- will file claims for you.
| This chart shows how much you pay for certain dental services: |
Delta Delta DPO dentist When you need dental care, you pay |
Non-Delta Delta DPO dentist When you need dental care, you pay |
| Annual Deductible |
$50 per person / $150 per family each calendar year |
$50 per person / $150 per family each calendar year Out-of-Network Providers paid at 80th percentile and can balance bill |
| Preventive & Diagnostic Care (2 exams & cleanings per person per year) |
No charge |
No charge |
| Basic Treatment |
20% |
20% |
| Major Treatment (Your dentist must file a treatment plan so that you can get an estimate of Plan benefits before you receive this treatment.) |
50% |
50% |
| Orthodontic Treatment (Includes adults) |
50% up to $3,500 Lifetime Max. |
50% up to $3,500 Lifetime Max. |
If there is ever a question about this benefit, or if there is a conflict between the information in this summary and the formal language of the Plan documents, the formal wording in the Plan documents will govern. Please note the benefits described in this summary may be changed at any time and do not represent a contractual obligation on the part of Locke Lord LLP.
