Click Here for Important Dental Notice
as of April 1, 2008

CCPOA Dental
Rank & File Members

Western Dental is the main provider of dental services for Bargaining Unit 6 during the first 12 months of employment.
After the first 12 months of employment, the Trust offers BU6 participants several dental service choices:

Western Dental - A Prepaid Dental Plan.
Overview
www.westerndental.com

Primary Dental -  A Traditional Indemnity Plan.
Overview

First Dental Health  - PPO & EPO network
(Only for Primary Dental Members and Only in Participating Areas).
Overview
www.firstdentalhealth.com

 

Western Dental


This prepaid dental program provides you and your dependants the services of a WD provider. Western Dental dentists are located throughout urban California. Most basic services are covered at no cost.

Western Dental is the main provider of dental services for all BU6 members during the first 12 months of service and remains an excellent choice annually at open enrollment. Western Dental provides excellent service with low out-of-pocket expense.

 

CCPOA Primary Dental


CCPOA's Primary Dental Program is an indemnity, or fee-for-service, plan and does not require you use a provider network though a provider network does exist. You may select any dentist anywhere in the world. Participants within the Primary Dental program are, however, encouraged to use CCPOA's Preferred Provider Organization Network Dentists.

The plan sets limits (usual and customary amounts) that it will pay for each type of dental treatment. You are responsible for paying any remaining balance that might be due based upon the type of dental treatment received. A premium co-payment is deducted from your monthly pay warrant.

Additionally within Primary Dental, First Dental Health is a cost saving network for Primary Dental members in certain participating areas. The Trust presently contracts 2 networks: EPO and PPO through First Dental Health.

CCPOA Benefit Trust Fund    Primary Dental Plan

Non-Contracted Provider:

First Dental Health Providers:

Calendar year maximum: $2000/ per person
Combined Dental & Orthodontic Deductible:
Per calendar year
Individual: $50
Family: $150
Deductible is waived on Preventive/Diagnostic Services
Services are payable based on CCPOA allowable amount

 Calendar year maximum: $2000/per person
Deductible: None
Services are payable based on Contract Rate through First Dental Health EPO/PPO

This is not a guarantee of payment but a summary of benefits available through the CCPOA Primary Dental Plan. Benefits are subject to eligibility, terms, conditions, and limitations of the participant’s dental coverage in force at the time the services are actually rendered. Certain services are subject to review.

Preventive/Diagnostic Services
100%
Prophy: Twice in the calendar year (anytime)
Fluoride: Under age 15, twice in a calendar year
Sealants: No age limit, on permanent unrestored posterior molars only. 36-month limitation, (eff 2/2/09)
Bitewing: Unlimited, unless done with Panographic or more than 10 PA’s.
Panographic: Unlimited while taken alone.
FMX: Once every 36 months
Exams: Unlimited. First exam is payable under preventive, all subsequent exams are payable under the basic benefit with no deductible,
Space Maintainers
Emergency Palliative Treatment		 Singles Crowns, Inlays, Onlays & Build-ups:
80% - PREP DATE - Porcelain crowns placed on molars will be paid as a full cast crown.
5-year replacement limitation
Prosthodontic (Major) Services
50% - PREP DATE
Initial preparation & installation of bridges
Crowns attached to a bridge
Initial preparation & installation of partial or complete dentures (including repairs)
Prior extractions are covered - effective 1/1/02
5-year replacement limitation
Congenitally missing teeth are covered
Basic Services
90%
Restorative Services: Composite porcelain & silver amalgam fillings. Composites on posterior teeth are reduced to the amalgam rate.
Endodontic Services: Root canal Therapy
Periodontal Services: Root Planning & Scaling: 24-month period. Perio charting is required. Pre-operative X-rays are necessary when pocket depths are under 4-mm.
Periodontal cleanings that are in conjunction with an active periodontal disease will be limited to two cleanings per year and only for the l8-month period following treatment of the periodontal disease.
Oral Surgery: Extraction of teeth & minor oral surgery
General Anesthesia. if provided in conjunction with a covered oral surgery procedure & only if determined by the Administrator to be Medically Necessary

Orthodontic Services: No age limit
50% to lifetime benefit $l000
including adjustments & retainers

Services Not Covered
TMJ
Occlusal guards/Night guards
Implants
Analgesia/Nitrous oxide
Coordination of Benefits: Standard
Pre-authorization is suggested over $300
Dependent children may be covered up to age 23 regardless of student status.

Download Primary Dental Plan Highlights

First Dental Health


First Dental Health is a cost saving network for Primary Dental members in certain participating areas. The Trust presently contracts two networks: EPO and PPO through First Dental Health.

If you use a First Dental Health dentist, the dentist has agreed to accept First Dental Health's usual and customary fee schedule as the cap for services. This amount is usually significantly less than what a dentist would charge under a normal indemnity or fee-for-service arrangement. If you are enrolled in CCPOA's Primary Dental Program, and are using a network provider, your annual 50/150 deductible is waived.

Website: www.firstdentalhealth.com