Dental Insurance

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The coverage under the ONA Dental Care Plan
provides comprehensive services to meet the
needs of Members and their families.


Dental care plan:

  • 80% Preventative Services, including:
    • Oral examinations once every 6 months
    • Cleaning, polishing, and fillings
    • Scaling (8 units every 12 months)
  • 80% Restorative Services (Endodontic & Periodontic), including:
    • Extractions and root canal treatment
    • Treatment for diseases of tissue and gums
  • 75% Major Restorative Services, including:
    • Installation of crowns
    • Replacement of dentures or fixed bridges
    • Oral surgery
  • 50% Orthodontic Services*:
    • For children up to age 19
    • Limited to a lifetime maximum of $2,000 per insured

Combined annual maximums for preventative, restorative and major restorative services is $1,200 per insured person, per calendar year.

As a new member or if you are losing coverage, you can enroll in the Dental Plan without limitation** (subject to being actively at work) within 60 days of:

  • the first day you became an ONA Member;
  • the day you lost coverage due to a change from full-time to part-time status;
  • the day you lost coverage under your (or your spouse’s) employer benefit program, or any other group plan; or
  • the day you lost coverage due to retirement.


Additional information on plans and application form: 

File Dental Rates 2017.docx

Application Form for Health and Dental


Please complete the above application, save, and submit to along with any supporting documents.


* Orthodontic coverage becomes effective 24 consecutive months after your first day of coverage.


**If you do not qualify for the 60-Day Open Enrollment you are considered a Late Applicant and your Dental coverage is limited to $200 per insured during the first 12 months of coverage.

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