Dental Indemnity
ods-Ddelta
dental
protective dental
Dental PPO
ods-Ddelta
dental
Dental HMO
cigna
delta dental
denticare
pacific dental
liberty dental
Vision Plans
Disability/Life
Liberty Dental Plan
California Only
Listed here are the complete plans for your viewing.
If you need Adobe Acrobat to read the following benefit summaries click the following
link. Download Adobe
Acrobat .
PPO will be coming soon!
California HMO
California HMO
For a list of Liberty Dental Plan
providers
Rates! Per pay period. Listed separately by type of membership. Includes discounted rates for selecting both a dental and vision plan. The vision plan is provided by Vision Service Plan for the Dental + Vision and can be viewed here.
Rates are Effective 10/01/2004 through 9/30/2005
CA 50 Rates |
Dental + Vision |
Dental Only |
||
Union Member |
Associate Member |
Union Member |
Associate Member |
|
Employee |
$14.95 |
$20.95 |
$8.78 |
$14.78 |
Employee + 1 |
$21.19 |
$27.19 |
$12.87 |
$18.87 |
Employee + Fam |
$29.48 |
$35.48 |
$17.75 |
$23.75 |
Rates are Effective 10/01/2004 through 9/30/2005
CA 90 Rates |
Dental + Vision |
Dental Only |
||
Union Member |
Associate Member |
Union Member |
Associate Member |
|
Employee |
$12.25 |
$18.25 |
$6.08 |
$12.08 |
Employee + 1 |
$15.34 |
$21.34 |
$7.02 |
$13.02 |
Employee + Fam |
$20.35 |
$26.35 |
$8.61 |
$14.61 |
Forms to Print! Click on the desired
form to enlarge the view and select print from you web browser. If you do not have
acces to a printer see our contact information below. Please mail all forms and
correspondence to NWPA. You will need to Adobe
Acrobat to read the enrollment form and union direct deposit form.
A copy can be obtained from the following link. Download Adobe Acrobat
 |
|
|
| Liberty Dental enrolment form |
IFPTE Member
direct deposit form. |
Associate Member direct deposit form. |