Learn more about Dental Insurance
Dental Plan Design
Humana Dental
You will have access to view and print your dental ID cards via the website or mobile app after you receive your Human Dental ID card. Here's how:
- Go to humana.com and sign in/register for MyHumana (Have your Humana member ID)
- Click "Access Your ID Card" under "Tools & Forms" in the lower right of your MyHumana home page or in the page's footer under "Tools & Resources"
- A new window will appear with links to the ID card or proof of coverage
- Print if desired
This is only a summary of benefits and not a contract. Please refer to your summary plan description for complete details.
Humana Dental Claims Office
PO Box 14611
Lexington, KY 40512-4611
Dental 1
(Standard Plan)
In-Network
Calendar Year Deductible (Individual / Family)
$25 / $50
Calendar Year Maximum
$1,000
(excludes orthodontia and surgical extraction of wisdom teeth benefits)
Preventive & Diagnostic Services
Covered 100%
(no deductible)
Basic Restorative Services
Plan pays 70% after deductible
Major Restorative Services (3 month waiting period)
Plan pays 50% after deductible
Surgical Wisdom Teeth Extraction(s)
80% of the covered services, after deductible, up to $1,000 annual maximum
Orthodontia (6 month waiting period)
50% of the covered services, up to $1,000 lifetime orthodontia maximum
Out-of-Network1
Calendar Year Deductible (Individual / Family)
$25 / $50
Calendar Year Maximum
$1,000
Preventive & Diagnostic Services
Covered 100%
Basic Restorative Services
Plan pays 70% after deductible
Major Restorative Services (3 month waiting period)
Plan pays 50% after deductible
Surgical Wisdom Teeth Extraction(s)
80% of the covered services, after deductible, up to $1,000 annual maximum
Orthodontia (6 month waiting period)
50% of the covered services, up to $1,000 lifetime orthodontia maximum
Dental 2
(Buy-Up Plan)
In-Network
Calendar Year Deductible (Individual / Family)
$25 / $50
Calendar Year Maximum
$2,500
(excludes orthodontia and surgical extraction of wisdom teeth benefits)
Preventive & Diagnostic Services
Covered 100%
(no deductible)
Basic Restorative Services
Plan pays 90% after deductible
Major Restorative Services (3 month waiting period)
Plan pays 60% after deductible
Surgical Wisdom Teeth Extraction(s)
80% of the covered services, after deductible, up to $2,500 annual maximum
Orthodontia (6 month waiting period)
50% of the covered services, up to $1,000 lifetime orthodontia maximum
Out-of-Network1
Calendar Year Deductible (Individual / Family)
$25 / $50
Calendar Year Maximum
$1,000
Preventive & Diagnostic Services
Covered 100%
Basic Restorative Services
Plan pays 70% after deductible
Major Restorative Services (3 month waiting period)
Plan pays 60% after deductible
Surgical Wisdom Teeth Extraction(s)
80% of the covered services, after deductible, up to $1,000 annual maximum
Orthodontia (6 month waiting period)
50% of the covered services, up to $1,000 lifetime orthodontia maximum
- Out of network coinsurance will pay the same percentage, but the reimbursement is based on out of network rates. You may be balance billed for the difference.
To ensure you do not receive additional charges, visit a participating in-network dentist. Members and their families benefit from negotiated discounts on covered services by choosing dentists in-network. If a member visits a participating in-network dentists, the member will not receive a bill for charges more than the negotiated fee for covered services. If a member sees an out-of-network dentist, coinsurance (%) will apply to the usual and customary charge.
Preventive
Procedures that dentists use to diagnose, monitor, and maintain a patient's oral health:
- Cleaning and oral exam
- Fluoride treatment
- Sealants
- X-rays
Basic
Treatments that are relatively straightforward and don’t involve a significant laboratory expense:
- Filling
- Tooth removal
- Root canal
- Anesthesia
Major
Procedures that are more complex and often involve a dental laboratory expense:
- Bridges and dentures
- Crowns, bridges, and dentures (repair & maintenance)
Orthodontia
Specialist care and corrective action to align bite and/or straighten teeth:
- Appliances, including braces and retainers
Contribution Rates
Pre-Tax Contributions (19 Pay Periods)
Free employee only Dental 1 coverage provided by SJCSD
Employee Only
Dental 1 (Standard Plan)
$0.00
Dental 2 (Buy-Up Plan)
$6.15
Family w/ 2 Single**
Dental 1 (Standard Plan)
$0.00 ($0.00 per employee)
Dental 2 (Buy-Up Plan)
$12.30 ($6.15 per employee)
Family w/ 2 (Children)*
Dental 1 (Standard Plan)
$5.08 ($2.54 per employee)
Dental 2 (Buy-Up Plan)
$30.50 ($15.25 per employee)
Employee & Family
Dental 1 (Standard Plan)
$21.47
Dental 2 (Buy-Up Plan)
$48.88
- Changes made during Open Enrollment will result in adjusted “Pro-Rated” premiums from January 15, 2027, to May 28, 2027. Deductions through May 28 provide coverage until September 30, even if employment at SJCSD does not continue into the 2027-2028 school year. Continuation of employment means resuming standard premium rates, but rates may vary with any plan year increases.
- Please note: Premium deductions are taken out pre-tax with your permission.
- *Family with 2 (Children) - Both you and your spouse are employed full-time with SJCSD with children enrolled on the insurance policy. The total premiums will be divided equally among both employees' paychecks.
- **Family w/2 Single Rate - Both you and your spouse are employed full-time with SJCSD with NO children enrolled on the insurance policy. Both Employees are considered Family w/2, both premiums will be deducted at the SINGLE rate for each employee.
Contact the provider of these benefits by calling this phone number or visiting this website: (800) 233-4013, humana.com
Group #673584