Eligibility

If you are a benefits-eligible employee, you may enroll for dental insurance. You may also enroll your eligible dependents for coverage. All eligible employees can enroll for employee only coverage, employee plus spouse coverage, employee plus child(ren) coverage or family coverage within 31 days of their hire date or during the annual open enrollment period. Employees also have 31 days from a qualifying event to make changes to their coverage.

Expense

The College pays a majority of the premium for dental coverage for you and any eligible dependents you elect to enroll. You pay the remaining portion of the premium expense by payroll deduction. The Tax Saver Program lets you make these deductions on a before-tax basis. For more information on Tax Saver, see the chapter entitled “Other Benefits.”

About the Plan

You have a choice of how your dental benefits are provided. You may select the Traditional PPO Dental Plan, or, where available, the Dental Maintenance Organization Plan (DMO). Each provides quality service.

These two options are compared below.

Traditional PPO Dental Plan

The Traditional PPO Dental Plan offers you and your enrolled family members dental benefits without requiring payment of a deductible for preventative procedures. You may use in- or out-of-network dental care providers for treatment. For preventative work, such as exams and cleanings, this plan will pay 100% of the cost for in-network providers, and 100% of usual, reasonable, and customary (UCR) costs for out-of-network providers. For basic services, such as fillings or root canals, and for major dental work, such as dentures, the plan will pay 80% of the cost for in- network providers, and 80% of UCR for out-of-network providers after the $50/person or $150/family deductible has been met. The calendar year maximum benefit for all services other than orthodontia is $1,500 per person. This plan offers an orthodontia benefit for dependent children up to age 19 of 50% of cost, with an individual lifetime maximum benefit of $1,000. The orthodontia benefit applies to both in- and out-of-network providers.

Dental Maintenance Organization Plan

The Dental Maintenance Organization (DMO) Plan does not require a deductible. You choose your primary care dentist from a network of dental care providers supplied by the DMO. These dentists have agreed to provide dental services at reduced fees to DMO participants. The DMO plan covers 100% of charges for any preventative work or basic repairs after your $5 co-pay, and 50% to 75% of major dental work. There is no annual maximum benefit under the DMO plan. When you enroll in the DMO you pay only your portion of the bill. There are no claim forms to fill out and no waiting for reimbursement. This plan also offers an orthodontia benefit for dependent children and for adults that includes evaluation, treatment, and retention with a specific schedule of benefits for each stage of the process. The orthodontia benefit applies to DMO providers only.

To determine which plans are offered in your region, please visit the College's benefits website at www.gregoryappel.com/ivytech.edu.

For complete details of the plan and the procedures covered, please refer to your dental plan booklet.