Dental Coverage

Which Plan?	Who will be covered?	Payment Method	Biweekly	Monthly	Quarterly	Semi- Annual	Annual
Basic Delta Dental PPO	Member	NSA Payroll Allotment	$12
		Direct bill from GEBA			$78	$156	$312
		Auto Debit from Bank		$26	$78	$156	$312
	Member Plus One	NSA Payroll Allotment	$22
		Direct bill from GEBA			$143	$286	$572
		Auto Debit from Bank		$47.67	$143	$286	$572
	Member Plus Family	NSA Payroll Allotment	$29
		Direct bill from GEBA			$188.50	$377	$754
		Auto Debit from Bank		$62.83	$188.50	$377	$754

Which Plan?	Who will be covered?	Payment Method	Biweekly	Monthly	Quarterly	Semi- Annual	Annual
Enhanced Delta Dental PPO	Member	NSA Payroll Allotment	$20
		Direct bill from GEBA			$130	$260	$520
		Auto Debit from Bank		$43.34	$130	$260	$520
	Member Plus One	NSA Payroll Allotment	$39
		Direct bill from GEBA			$253.50	$507	$1,014
		Auto Debit from Bank		$84.50	$253.50	$507	$1,014
	Member Plus Family	NSA Payroll Allotment	$57
		Direct bill from GEBA			$370.50	$741	$1,482
		Auto Debit from Bank		$123.50	$370.50	$741	$1,482

Electing direct bill on a quarterly or semi-annual basis will incur a $2.00 service fee. Direct bill on an annual basis will not incur this service fee.