Health Service System - City & County of San Francisco

This PPO-style dental plan gives you the freedom to visit any in-network or out-of-network dentist that you choose. The plan pays higher benefits (and you pay less) when you visit an in-network dentist. Delta Dental provides three options for selecting a dental provider. Each option provides coverage for the same types of services, but at different benefit levels.

DeltaPreferred Option (DPO): For the lowest out-of-pocket expense, you can visit a DPO network provider. DPO level benefits are available from more than 12,000 DPO offices in California. Significant cost savings are available when visiting a dentist in the DPO network through negotiated lower fees on services.

DeltaPremier: Considerable savings are also available when using a DeltaPremier provider. Your out-of-pocket expense may be greater than when using a DPO provider.

Non-Delta Dental Providers: You may elect to receive services from any licensed dental provider. Providers who do not participate in the Delta Dental network generally charge fees that are higher than those charged by providers who participate in the network, resulting in higher out-of-pocket costs to you.

Active Employees	Retired Employees
July 2009 - June 2010	July 2009 - June 2010
Summary of Benefits	Summary of Benefits
Evidence of Coverage	Evidence of Coverage

 

To contact Delta Dental, visit the Delta Dental website or call Delta Dental at (888) 335-8227. The active employee group number for Delta Dental is 9502-0003. The retiree group number is 1673-0001.