5.9 Group Dental Insurance
A comprehensive dental insurance program is available for benefit-eligible employees and their spouses and/or same- or opposite-sex domestic partners and their children. (See definition of a domestic partner in section 5.7.3.)
Participation is optional and becomes effective on the date of employment if elected.
Please contact the Office of Human Resources for current premiums and rates of participation.
Definitions and Brief Plan Description
Preventative Services - Oral exams, teeth cleaning, x-rays, fluoride treatment for children, space maintainers and topical sealants for children, etc.
Basic Services - Diagnostic services, restorative services, endodontics, certain periodontic services, oral surgery, certain prosthodontic services, general anesthesia, injectable antibiotics, etc.
Major Services - Restorative services, prosthodontic services, etc.
Orthodontia Services - Covers braces and appliances for children to the age of 19. There is a lifetime maximum of $1,000 per covered child.
Benefit Levels: No Network
All dental charges will be subject to UCR. UCR stands for usual, customary and reasonable. This plan will utilize the 90th percentile (9 out of 10 dentist's charges will fall at or below the amount the plan will allow for a particular procedure). You may be responsible for payment on any amount above the UCR.
Deductible: None for preventative. $50 per plan year (July 1 through June 30) for basic and major services, limited to only three deductibles per family.
Benefit Level Maximum: Maximum of $1,000 per covered person per year.
Dependent Children: Covered to the end of the month in which the child attains the age of 26.
(edited July 2010, May 2012)