Dental plans and rates

Child dental coverage

All off-exchange Kaiser Foundation Health Plan HMO and Kaiser Permanente Insurance Company, Inc. (KPIC)1 PPO metal plans cover the ACA-defined essential health benefits, which include child dental services.

  • HMO members receive child dental benefits through a separate child dental plan underwritten by Delta Dental of California (DeltaCare® USA).
  • PPO members receive child dental benefits as part of their health coverage and not as a separate health insurance plan.
  • Child dental services apply to all members up to age 19. Coverage for an HMO member who turns 19 extends through the date of their group plan contract renewal date. Coverage for a PPO member who turns 19 extends through the end of the month they turn 19.

Grandfathered (nonmetal) HMO plans2 don’t include child dental coverage, but supplemental child dental coverage may be purchased and paired with a grandfathered (nonmetal) HMO plan. In this case, child dental coverage is available up to age 26. Supplemental coverage can only be added to a grandfathered (nonmetal) HMO plan during the health plan renewal period.

Child dental plan summaries

Use these summaries to see detailed benefit information for each child dental plan.

Child dental questions and answers

Here are answers to some frequently asked questions about off-exchange child dental coverage, as well as coordination of benefits when your clients offer a family dental plan paired with an off-exchange Kaiser Permanente metal plan.

Information about supplemental family dental plans

Use these questions and answers when selling off-exchange supplemental family dental plans or share them with your customers. They include instructions on how to register online and receive services from Delta Dental.

Supplemental family dental plans (optional)

We offer 3 types of family dental plans to meet your clients’ needs — KPIC Premier fee-for-service, KPIC PPO, and DeltaCare HMO. Please note that the DeltaCare HMO family dental plan can’t be offered with any PPO health insurance plans.

  • When your clients offer a family dental plan, each subscriber and dependent enrolled in the Kaiser Permanente health plan must also be enrolled in the dental plan. This includes adults and dependent children up to age 26 (if you offer your employees dependent coverage).
  • Family dental plans can be paired with either metal or nonmetal HMO plans.2
  • Supplemental dental coverage offers potential cost savings for certain child dental services if there is coordination of benefits between the HMO or PPO metal plan and the family dental plan.
  • Family dental plans can only be purchased when your group first enrolls or at renewal. 
  • Family dental plans are only available to your clients’ employees enrolled in a Kaiser Permanente health plan.

Note: Family dental plans are not a substitute for the child dental coverage required by the ACA for members under 19. That coverage is included in the Kaiser Permanente health plan. The family dental plan is in addition to that coverage.

Here’s an overview of our plan types through Delta Dental:

 

Benefit KPIC fee-for-service plan3 KPIC PPO plan3 DeltaCare® USA plan
Flexibility and choice Members can see any licensed dentist, including any Delta Dental PPO provider, for the same cost share. Members can see any licensed dentist. However, their health insurance plan benefits are richer if they see a Delta Dental PPO provider. Members must visit assigned DeltaCare® USA dentists
Network access Delta Dental PPO and Delta Dental PremierSM ® Delta Dental PPO and Delta Dental PremierSM ® DeltaCare® USA only
Premium cost Highest Moderate Lowest
Cleanings and exams Covered Covered Covered
Claim forms Not with network providers Not with network providers Not with network providers
Deductible Yes
(except Plan C)
Yes No
Plan limits Yes Yes No

 

Information for your clients’ employees

You can share this value-of-dental-care flyer with their employees to demonstrate the benefits of having dental services included in their coverage.

For more dental plan and benefit information, contact your account manager or call our Account Management Support Team at 1-800-790-4661, option 3.

Family dental plan comparison summaries

Use these summaries to compare the benefits and rates for all 3 dental plan options in each service area.

2022
Effective January 1 to December 1, 2022
2021
Effective January 1 to December 1, 2021
2020
Effective January 1 to December 1, 2020

Family dental plan summaries by plan

Use these summaries to see detailed benefit information for each dental plan.

1Kaiser Permanente Insurance Company (KPIC), a subsidiary of Kaiser Foundation Health Plan, Inc., underwrites the Kaiser Permanente Preferred Provider Organization (PPO) Plan.

2Kaiser Permanente Insurance Company (KPIC) PPO plans for small business are limited to non-grandfathered PPO metal plans only.

3This dental insurance plan is underwritten by Kaiser Permanente Insurance Company
a subsidiary of Kaiser Foundation Health Plan, and administered by Delta Dental of California.