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Choosing a dental option outside of the coverage area may be extremely ... Employees may use a PPO provider even if enrolled in the Regular Dental Option. ... – PowerPoint PPT presentation

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Title: Title goes here this sample illustrates a twoline title This is a sample subtitle


1
FLEXIBLE BENEFITS

2009
2
DENTAL
UNITED CONCORDIA CIGNA
3
DENTAL INSURANCE
DENTAL
  • Eligibility is determined based on where an
  • employee lives.
  • Regular Option available in all areas.
  • PPO Option available in Metro Atlanta,
  • Augusta, Columbus,
  • Macon, Valdosta
  • Savannah
  • Prepaid Option available in Metro Atlanta

4
DENTAL INSURANCE
DENTAL
If an employee does not live in a PPO or Prepaid
covered area, he/she may still choose either
option. However, they must complete the on-line
Residence Waiver form
NOTE
Choosing a dental option outside of the coverage
area may be extremely inconvenient, if provider
is not in close proximity to where employee lives.
5
DENTAL INSURANCE
DENTAL BENEFITS COMPARISON
Regular PPO Prepaid 100
100 100 80 90 100 50
50 60 50 50 50
Dependents Dependents Employee under 19
under 19 all eligible
dependents
Preventive Basic Major Orthodontia
Of the 90th percentile
Employees may use a PPO provider even if enrolled
in the Regular Dental Option. This may result in
lower out-of-pocket costs
6
DENTAL INSURANCE
DENTAL SERVICE CATEGORIES
  • Type I (Preventive)
  • Cleanings, Oral Exams, X-rays
  • Type II (Basic)
  • Fillings, Root Canals, Extractions, Scaling, and
    Root Planing
  • Type III (Major)
  • Crowns, Bridgework, Periodontal Surgery

7
OPEN ENROLLMENT 2009
IMPORTANT NOTE
  • For the Regular PPO Dental options
  • Preventive or Type I services (e.g. Oral Exams,
    Cleanings, and X-rays) are excluded from the
    1,000 annual maximum
  • Increases the annual maximum available for Basic
    and Major services during the year

8
DENTAL INSURANCE
DENTAL BENEFIT PROVISIONS REGULAR PPO
Annual 50 per person 150 family
(for Basic Deductible Major
services) Maximum 1,000 per person per
plan year (for Basic Major services)
1,500 lifetime benefit
for Ortho Waiting New
employees or newly enrolled Period
dependents Major Ortho Late Entrant
Current employees enrolling for 1st
time Limitations Basic, Major, Ortho
After 6 months continuous coverage After 12
months continuous coverage for Basic after 24
months continuous coverage for Major Ortho
9
DENTAL INSURANCE
DENTAL REGULAR PPO LATE ENTRANT LIMITATIONS
  • Applies to
  • Current employees enrolling for first time or
    re-enrolling after discontinuing coverage
  • Employees who do not enroll when first eligible
  • Employees who fail to pay premiums when on leave
    without pay
  • Not Apply to
  • Employees transferring between dental options
  • Employees enrolling when first eligible
  • Employees enrolling due to qualifying change in
    status

10
DENTAL INSURANCE
UNITED CONCORDIA REGULAR PPO
  • Phone number 1-866-215-2356
  • You may go online http//www.ucci.com/was/ucciweb
    /clients/georgia.jsp
  • Mailing address
  • United Concordia
  • P.O. Box 69420
  • Harrisburg, PA 17106-9420

11
DENTAL INSURANCE
PREPAID DHMO (CIGNA)
  • No claim forms to complete
  • No dollar maximums
  • No deductibles
  • No late entrant limitations
  • No waiting periods
  • Budgetable Dental Care all patient charges
    listed on Patient Schedule Charge

12
DENTAL INSURANCE
PREPAID DHMO REMINDERS
  • You must see a Network Dentist to receive
    benefits
  • You must complete and submit a Dental Selection
    Form

13
DENTAL INSURANCE
PREPAID DHMO REMINDERS
  • An individual may change their Network Dentist by
    contacting CIGNA Customer Service Department toll
    free
  • If the change request occurs by the 15th of the
    month, the change will be effective the first day
    of the following month. After the 15th, the
    change will be effective the first day of the
    second following month

14
DENTAL INSURANCE
PREPAID DHMO
  • CIGNA toll free Customer Service Department phone
    number 1-800-642-5810
  • To locate a participating provider
    http//provider.healthcare.cigna.com/gms.html

15
DENTAL INSURANCE
CLAIM FORMS
Located in the Forms section on Team Georgia
16
BENEFIT OPTIONS AFTER RETIREMENT
17
DENTAL INSURANCE
DENTAL
  • Deductions taken by ERS
  • Must be currently enrolled in dental
  • Receiving an immediate and sufficient ERS benefit
  • Plan design remains the same
  • Premiums remain the same (After tax)

18
DENTAL INSURANCE
DENTAL
  • Must submit retiree dental enrollment form within
    60 days of retirement
  • No Open Enrollment period for retirees
  • Benefit rolls over automatically
  • Changes may be made anytime during the Plan Year
    due to a Qualifying Change of Status

19
DENTAL INSURANCE
SPA CONTACT INFORMATION
  • Agencys website www.spa.ga.gov
  • Information Regarding Flexible Benefits
    http//team.georgia.gov/portal/site/FLEX
  • Phone Numbers
  • Local 404-656-2730
  • Toll Free 1-888-968-0490

20
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