Dental Plans

The Lesley University Dental Plan offers employees and their eligible family members two Delta Dental insurance options: DeltaPremier and DeltaCare II. When reviewing the material, it is important to note the plan services and procedures for obtaining these services, as there are variations between the plans. These variations are outlined in the dental plans comparison. Information provided on this site should provide employees with the tools and resources necessary to make an informed decision about your and/or your eligible family members' dental care needs and to select a plan to meet these needs.

Please note: This site provides an overview of Lesley's dental insurance offerings. If there is a discrepancy between the descriptions here and official plan documents and policies, the documents and policies govern. Lesley reserves the right to change its benefit plans at any time.

Delta Premier

In-Network Coverage and Co-Payment

Under DeltaPremier, preventative and diagnostic services require co-insurance payments and/or deductibles depending on whether the services are classified by DeltaPremier as Type I (preventive), Type II (basic restorative), or Type III (major restorative).  Type I services are covered in full (100%).  Type II and III services require that you pay a $100 deductible for individual coverage and $300 for family coverage before receiving benefits from the plan. After this deductible has been satisfied, DeltaPremier requires a 20 percent co-insurance payment for Type II services, and a 50 percent co-insurance payment for Type III services. A comprehensive listing of the services covered under each tier can be found in the DeltaPremier benefit summary available in the Human Resources Department.

Note that unlike DeltaCare, DeltaPremier provides no coverage for orthodontia services. Additionally, DeltaPremier requires that you pay a deductible for services you receive. An important thing to be aware of as well is that a calendar year maximum exists of $1,000 per person per calendar year. This means that DeltaPremier will not pay for any costs you incur during a calendar year that exceed $1,000. Please refer to the DeltaPremier benefit summary for more information. Because of this, DeltaPremier recommends that you ask your dentist for a pre-treatment estimate for procedures expected to exceed $300. With this information, DeltaPremier will be able to figure out any out-of-pocket costs that you might incur.

Out-of-Network Coverage

DeltaPremier provides coverage for out-of-network services, but benefits received are much lower than coverage received in-network. They are dependent upon the usual and customary fees available in the geographic area in which they are received. Please see benefit plan summary description for more information.

DeltaCare II

Choosing a Primary Care Dentist

Lesley's participation in Delta Dental's DeltaCare Plan provides enrollees the option to choose from more than 500 participating dentists. Of these, you and your family members (if applicable) choose a Primary Care Dentist (PCD) who will be your primary service provider. Lists of eligible providers can be found on the Delta Dental Web site or in directories located in the Human Resources Department. Your PCD will coordinate all dental care services. They will be the first point of contact in understanding your dental care needs and history. If your PCD leaves the network at any time during the plan year, DeltaCare will automatically reassign you to a dentist in your general geographic area. If you are not comfortable with the PCD Delta Dental has selected for you, you may call them directly at (800) 327-6277 to select a PCD of your choice.

In-Network Coverage and Co-Payment

Under DeltaCare, most preventative and diagnostic services under this plan are covered 100 percent as long as they are considered in-network. Other services require co-payments payable directly to the dentist. A listing of applicable co-payments can be found in the DeltaCare benefit summary available in the Human Resources Department.

In addition to usual services, DeltaCare also covers services received for orthodontia care. For a listing of these services and applicable co-payments, please refer to your benefits summary. DeltaCare does not require that you pay any annual maximums or network deductibles for services you receive.

Out-of-Network Coverage

DeltaCare provides coverage for out-of-network services, but benefits received are much lower than coverage received in-network. The DeltaCare co-payment schedule does not apply if you go out-of-network, and that out-of-network benefits are based upon the dentist's charge or the usual and customary fee for the service. Please see the benefit plan summary description for more information.

Enrolling in the Dental Plan

An eligible employee can opt to enroll in the dental plan within thirty (30) days after date of hire by completing an enrollment form. Enrollment forms can be obtained in the Human Resources Department.

Lesley University offers two types of health coverage levels:

1. Individual (employee)
2. Family (employee and eligible family member(s)

Employees can also make changes to their health or dental plan elections during open enrollment. Open enrollment usually occurs in the fall, and all changes are effective January 1 of the coming year

Changes during the course of a year are allowed only if a qualifying event occurs. Please see the section on Qualifying Events for more information.