Delta Dental

For Groups in CA

Delta Dental

Since their inception in 1955, Delta Dental¹ has been creating smiles and improving health. This is especially true when it comes to their plans for individuals.

Enter ZIP code and select PPO or DeltaCare USA as the network:

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Voluntary Delta Dental Benefits and Rates
2026 Delta Dental HMO — benefits and rates
2026 Delta Dental PPO — benefits and rates
2026 Delta Dental PPO (Premier) — benefits and rates

Member Benefit Summaries (MBS)
00465-02700/02701 Q – VOL PPO 100/80/50 $1,500 w/Ortho
00465-02800/02801 R – VOL PPO 100/80/50 $2,000
00465-02900/02901 S – VOL PPO 100/80/50 $2,000 w/Ortho
00465-03000/03001 T – VOL PPO (Premier) 100/80/50 $1,500 w/Ortho
00465-03100/03101 U – VOL PPO (Premier) 100/80/50 $2,000
00465-03200/03201 V – VOL PPO (Premier) 100/80/50 $2,000 w/Ortho
00465-03400/03401 X – VOL PPO (Premier) 100/80/50 $3,000

71989-00030 DeltaCare HMO 12A – Reg 1 & 2
71989-00031 DeltaCare HMO 12A – Reg 3
71989-00032 DeltaCare HMO 12A – Reg 4
71989-00033 DeltaCare HMO 12A – Reg 5

Sunset Plans
00464-01300/01301 A – Premier $50 80/80/50 $1,000
00464-01400/01401 C – Premier $50 100/80/50 $1,000
00464-01600/01601 E – Premier $50 100/80/50 $1,500
00465-01700/01701 F – PPO $50 100/80/50 $1,000
00465-01800/01801 G – PPO $50 100/80/50 $1,500
00465-01900/01901 H – PPO $50 100/80/50 $1,000 w/Ortho
00465-02000/02001 J – PPO $50 100/80/50 $2,000

Evidence of Coverage (EOC)
100/80/50 $1,500 With Ortho
100/80/50 $2,000
100/80/50 $2,000 With Ortho
100/80/50 $1,500 With Ortho
100/80/50 $2,000
100/80/50 $2,000 With Ortho
DeltaCare (VOL) DHMO #71989 (Region 1 & 2)
DeltaCare (VOL) DHMO #71989 (Region 3)
DeltaCare (VOL) DHMO #71989 (Region 4)
DeltaCare (VOL) DHMO #71989 (Region 5)

Additional Benefits (For CA only):
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For Groups in CO

Delta Dental is the nation’s largest provider of dental insurance, covering more than 80 million Americans, and offering the largest dental network with approximately 157,000 participating providers nationwide.

Search For Providers
deltadentalco.com

Voluntary Delta Dental benefits and rates
2026 Delta Dental PPO (Premier) — benefits and rates

Member Benefit Summaries
Delta Dental CO PPO $750
Delta Dental CO PPO MAC $1000 with Ortho
Delta Dental CO PPO MAC $2000
Delta Dental CO PPO Premier $1500

Additional Plan Offerings
Claim form

Evidence of Coverage (EOC)
Delta Dental CO PPO $750 – W2881
Delta Dental CO PPO MAC $1000 with Ortho – W2884
Delta Dental CO PPO MAC $2000 – W2883
Delta Dental CO PPO Premier $1500 – W2882

All Other States

Voluntary Delta Dental in TX benefits and rates
2026 Delta Dental DPO and DPO (Premier) — benefits and rates

Member Benefit Summaries (MBS)
Delta Dental in TX – DPO $1500 – 22824-01200 B
Delta Dental in TX – DPO $1500 – 22824-01201 B
Delta Dental in TX – DPO $2000 w/ORTHO – 22824-01400 D
Delta Dental in TX – DPO $2000 w/ORTHO – 22824-01401 D
Delta Dental in TX – DPO $2000 – 22824-01600 F
Delta Dental in TX – DPO $2000 – 22824-01601 F
Delta Dental in TX – DPO $3000 w/ORTHO – 22824-01800 H
Delta Dental in TX – DPO $3000 w/ORTHO – 22824-01801 H

Evidence of Coverage (EOC)
Delta Dental in Texas – 22824