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 providing medical evidence (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:
Please complete the above application, save, and submit to [email protected] along with any supporting documents.
* Orthodontic coverage becomes effective 24 consecutive months after your first day of coverage.