Delta Dental of Illinois

A voluntary dental plan offering both a DHMO and PPO is available through Delta Dental ( Proof of relationship and eligibility must be provided to include spouse/ dependent children on the plan. A civil union partner meeting eligibility criteria may be covered.

  • Dependent children can be covered by Delta Dental plan up to the last day of the month that they turn 26.
2024 Dental Rates

*To-Go option allows PPO members to roll over unused benefit amounts to the following plan year when certain criteria are met. Members cannot accumulate roll over amounts greater than the $2,000 annual benefit maximum amount.

Related Documents and Forms

Delta Dental's Information

Dental Insurance Forms and Pamphlets - Delta Dental

  • Enrollment Form (contact Human Resources)
Claim Form (40.94 KB)
  • PPO
Benefit Summary (143.02 KB)
To Go Carryover (1.16 MB)
  • DeltaCare DHMO

Summary Plan Description

Note: You must have access to the Portal to download all of the documents below.

Changing my Dentist

The Delta Dental DHMO Plan allows each participant to change his or her dentist once per month; this change must occur by the 15th of the month to be effective the first of the following month. The participant should contact Member Services at 800.323.1743, and ensure the new provider is accepting new patients before switching providers.