Dental Program Overview

DENTAL PROGRAM

The company offers dental coverage through three different administrators: MetLife, Delta Dental and Cigna (where available). The MetLife and Delta Dental plan designs and monthly contributions are the same. The Cigna plan is a DHMO (Dental Health Maintenance Organization). Since the provider networks vary, be sure to check each of the administrator websites to select the network most appropriate for you and your family.

If you elect dental coverage, you can choose a coverage category that is different from your medical coverage category. You also have the option to waive dental coverage.

MetLife and Delta Dental Options

The MetLife and Delta Dental options pay all or a portion of the reasonable and customary costs of covered dental services, up to a maximum annual benefit of $2,000 per person. The plan provides benefits for:

  • Preventive and diagnostic care, such as routine check-ups, x-rays and cleanings — covered at 100% in-network and out of network (up to reasonable and customary limits)
  • Basic care, such as fillings, extractions, periodontal treatment, oral surgery, root canal and repairs to crowns, bridges and dentures
  • Major care, such as implants, inlays, onlays, and installation of crowns, dentures and bridgework, and
  • Orthodontia for yourself and your family (there is a lifetime maximum benefit of $2,000 per person for orthodontia.)

Before you can receive benefits for certain services, you must meet the annual deductible ($50 per person, $150 per family). The deductible does not apply to preventive and diagnostic services, or to orthodontia.

For procedures that cost more than $300, you may want to request a pre-treatment estimate. The pre-treatment estimate will detail what services the Plan will cover and at what payment level. To receive a “real-time” estimate, your dentist can contact MetLife or Delta Dental directly via the Internet or telephone.

Both options include network providers, which vary depending on where you live. If you use a network provider, you may pay a percentage of a discounted fee, which saves you money. If you use a non-network provider, your reimbursement will be based on reasonable and customary limits.

Metlife and Delta Dental Benefits 
Features  Benefits

Annual Deductible (excludes preventive and diagnostic)

· Individual

$50

· Family

$150

Plan Maximum*

$2,000

Preventive and Diagnostic Care

In-network: 100% / Out-of-network: 100%

Basic Care

80% after deductible

Major

50% after deductible

Orthodontia:

· Annual deductible

None

· Coinsurance

50%

· Lifetime maximum

$2,000

· Eligibility

All members


* Excludes orthodontia

For more information about coverage or to locate a participating provider, you can visit the MetLife website at www.metlife.com/dental (select the PDP network) or call 1-800-942-0854.

You can visit the Delta Dental website at www.deltadentalmn.org (select the PPO network; IA residents should select the Premier network) or call 1-800-448-3815.

Cigna Dental

In many areas you have the option of enrolling in the Cigna Dental Plan which is a Dental Health Maintenance Organization (DHMO). This works similar to a medical HMO in that there are no annual maximums, deductibles, reasonable and customary limits, or claim forms to file. Generally, you are responsible for a copayment for each service you receive. Copayments vary based on the service.

You must use a participating dentist in order to be covered. If you don’t, the plan will not pay for your services.

For more information about coverage or to locate a network dentist, you can visit the Cigna website at www.cigna.com (select the Cigna Dental Care (HMO) network) or call 1-800-842-4221. To view the reimbursement schedule, please visit the Benefits Website.

Before you decide on your dental coverage, consider the following:

  • Who do you need to cover?
  • What are your family’s typical dental expenses?
  • Can you get dental coverage through your spouse’s employer? If so, what is the cost and how much does that plan pay?
  • Is your dentist affiliated with the MetLife or Delta Dental network?

Keep in mind that you can be reimbursed from the Health Care FSA for dental expenses that exceed maximum plan benefits or for some services or expenses not covered by the plan.