Egyptian Area Schools Employee Benefit Trust Group #

Slides:



Advertisements
Similar presentations
Delta Dental of New Mexico Oral Health is Our Passion Quality Benefits, Quality Dentists … administering the dental program for State of New Mexico General.
Advertisements

Health Reimbursement Account (HRA) Program. What is a HRA? A Health Reimbursement Account (HRA) is an account funded by Troy University health insurance.
Assurant Provides A Choice of Dental Plans Freedom Preferred PPO Plan $25 Deductible In or Out of Network $2,000 Annual Maximum InOut Preventive*100%100%
Flexible Benefits Delta Dental. February APRIL 2010 Dental Plans – Delta Dental New! Effective January 1, 2013, Delta Dental will be replacing.
“We Believe Spirit is the Best Dental Plan in America!”
1 PPO Products and services marketed by Assurant Employee Benefits are underwritten or provided by Union Security Insurance Company. Prepaid Products and.
Welcome to Your Texas A&M System Dental Benefits Program.
Dental coverage Smile… What is covered? 100% coverage for Preventive Cleanings Xrays Exams Sealants through age 13 Paid at Lewiston rates. There.
Delta Dental of New Mexico  Oral Health is Our Passion Quality Benefits, Quality Dentists … administering the dental program for State of New Mexico.
DentalBlue Something to Smile About Lincoln County Health System.
2006 Benefits. 2 Comprehensive Health Care Plan  Choice of POS or HMO or no coverage  Payroll deduction amounts:  Qualified change in status - report.
Fairleigh Dickinson University Webinar Effective Date – January 1, 2010.
GoodHealthStartshere.org | DeltaDentalMO.com Odessa School District 2015 Open Enrollment.
Delta Dental benefits for University of California Santa Barbara Student Health Insurance Plan.
©UFS Horizon Carpentry Your MetLife Benefit Package.
Presented by Mark Weinstein, President & CEO and Robin Donovick, Chief Operating Officer March 22, 2011.
2013 Benefit Open Enrollment. Benefit Overview Medical Anthem continues as our carrier for 7/1/13 Choice of Traditional PPO and HDHP No plan design changes.
Medical Insurance. Overview  Many people in the US are uninsured – they assume all responsibility for health care costs.  The number of uninsured is.
1 University of St. Thomas 2015 Annual Enrollment Briefing.
OPS Open Enrollment− 1 OPS Employee Benefits ‒ Open Enrollment Who is Eligible: All full-time employees who worked, on average, 30 or more hours a week.
RETIREE LUNCHEON MARCH 23, Benefit Plan Update Medical Plan Changes –Non-network Option and HDHP Option now have unlimited Preventive.
Delta Dental of New Mexico  Oral Health is Our Passion Quality Benefits, Quality Dentists … administering the dental program for State of New Mexico.
Dental Insurance Protection For You And Your Family.
Your mouth says a lot about your health. Anthem is listening.. 1 CONFIDENTIAL.
PRESENTED BY: PEG HARMS & GINGER VERMEERSCH Insurance Services Open Enrollment Informational Session.
Benefits Summary and Education Session
1 University of St. Thomas 2016 Annual Enrollment Briefing.
HEALTH BENEFITS 101 Lucia Mar Unified School District Presented by Michelle Rogers Human Resources Technician May 11th, 2016.
OPEN ENROLLMENT 2016/17 Principle Solutions Group June 1, 2016 – May 31, 2017 Next.
Benefit Enhancements January 1, 2017 Vision Hearing Aid Dental.
PSC-CUNY WELFARE FUND A Program of Supplemental Health Benefits
Health Savings Account
Important Dates To Remember
Open Enrollment 2017 Please Note: The information contained in this presentation is summary information only. Please refer to your benefit plan documents.
UC Health Savings Plan UCSB Human Resources, Benefits 1
Health Insurance Options and Benefits.
Union public schools Open enrollment highlights
CompuSys/Erisa Group Inc
FSAFEDS Program Information
State of New Mexico Group Dental Benefits Plan
Insurance.
PARTNERS BENEFITS AT A GLANCE 11/1/2015 – 10/31/2016
2018 Medical Plans Comparison Tools and Resources
THE PRINCIPIA OPEN ENROLLMENT
Lawrence Berkeley National Laboratory Postdoctoral Scholar
Health Plan Overview & Updates
2018 Medical Plans Comparison Tools and Resources
Douglas County School District
BRIEF PLAN OVERVIEW FOR JULY 1, 2018 – June 30, 2019
Open Enrollment 2018 Please Note: The information contained in this presentation is summary information only. Please refer to your benefit plan documents.
Community College System of New Hampshire Employee Benefits Informational Sessions Community College System of New Hampshire Informational Sessions
Benefits Orientation RCAB Dental Plan
Open Enrollment 2018.
2019 Option Period Changes.
Welcome to Your Texas A&M System Dental Benefits Program
Benefits Overview.
Robins & Morton 2019 Benefits
Health Insurance Options and Benefits.
International Student Health Insurance Plan Overview
Get coverage for whatever comes your way.
PSC-CUNY WELFARE FUND A Program of Supplemental Health Benefits
Health Savings Account
Employee Benefits Open Enrollment
Health Savings Account
Employee Benefits Open Enrollment.
Open Enrollment 2019.
Presented by Steve Costello and Erin Devine of CBG Benefits
PSC-CUNY WELFARE FUND A Program of Supplemental Health Benefits
Barrier Busters: Ten Things To Know About Dental Options
Welcome to Your Texas A&M System Dental Benefits Program
Presentation transcript:

Egyptian Area Schools Employee Benefit Trust Group #010-350813 Highlight of Dental Options Hello, this presentation will provide an overview of the dental benefits offered through the Egyptian Area Schools Employee Benefit Trust. We will share information with you about Ameritas and touch on some of the plan details available to you and your covered dependents. By Ameritas group division

Employees can choose from two plans: High Plan or Low Plan Employees have the choice of two dental plans which allows you to pick the benefits and rate that best fits your needs.

Under either the High Plan or the Low Plan Employees can take single coverage or add dependent coverage Dependents receive the same plan chosen by the employee Employees can switch between plans at the annual election period Both plans allow employees to select single coverage or add coverage for eligible dependents. At the next annual election period, you can switch between plans without penalty.

See the highlight of the plan options Now let’s cover some of the highlights under both plans.

High Plan Highlight Orthodontia – for children 50% up to plan maximum Type 1 - Preventive procedures 100% (exams, cleanings, x-rays, child fluoride, etc.) Type 2 - Basic procedures 80% (extractions, fillings, sealants, root canals, treatment of gum disease, oral surgery, etc.) Type 3 - Major procedures 50% (crowns, crown repairs, dentures, bridges, implants, etc.) Orthodontia – for children 50% up to plan maximum Under the High plan, Type 1 Preventive procedures, such as exams, cleanings, and fluoride are considered at 100% of U&C. Type 2 Basic procedures like extractions, filings, sealants, treatment of gum disease, and oral surgery are considered at 80% of the maximum procedure allowance. The High Plan includes coverage for Type 3 Major procedures that includes treatment of crowns, dentures, bridges, and implants. These procedures are considered at 50% of the maximum procedure allowance. Orthodontic benefits for are available for children on the High Plan. Orthodontia is reimbursed at 50% up to the plan maximum. Please note. . . the coinsurance levels shown are reimbursed based on “U&C” or the “maximum procedure allowance” depending on the procedure type. Type 1 Preventive procedures are reimbursed based on the 90th U&C for the dentist’s zip code, meaning the 9 out of 10 dentist’s charges will fall within the amount Ameritas allows for Preventive procedures. Type 2 Basic and Type 3 Major procedures are reimbursed on the Maximum Procedure Allowance which is established according to the median dentist charges in the zip code where serves are provided.

High Plan Highlight Deductible Maximum Orthodontia Type 1 Procedures $10 per visit Type 2 & 3 Combined $50 Per Calendar Year Maximum deductible: three (3) family members Orthodontia None Maximum Annual Maximum Per Member $1,500 Orthodontia Lifetime Maximum Per Child $1,000 The High plan has no deductible on Type 1 Preventive procedures and a $50 calendar year deductible on Type 2 and 3 procedures combined. When three family members have satisfied their deductible, no further deductible is taken for the other family members for the rest of that year. There is no deductible on orthodontic benefits. The High plan has a dental maximum benefit of $1,500 per member. An additional $1,000 lifetime benefit is available for orthodontic benefits one time per lifetime per child.

High Plan Highlight Added notes about Orthodontia . . . Available up to age 19 Start by age 17 to receive the full orthodontic maximum Let’s take a moment and talk the orthodontic benefits . . . . -- Orthodontic benefits are available on the High Plan for children up to age 19. Since most orthodontic programs take two years to complete, the program needs to start by age 17 for the member to get the full orthodontic maximum benefit. -- For orthodontic programs that were covered under an insurance plan prior to your Ameritas effective date, and are in progress, Ameritas will provide takeover benefits that coordinate benefits between the old plan and the new plan to make sure members get the remaining maximum benefit. For example, if the old plan had paid $500 toward your orthodontic treatment plan, you would still be eligible for an additional $500 under the Ameritas plan. Ameritas reimburses orthodontic payments quarterly.

High Plan Highlight Ameritas Rewards! Utilize unused dental maximum to carryover towards dental benefits Or carryover up to $100 for additional orthodontia coverage Accumulate unlimited maximum dental carryover amount. Must submit dental claim during a benefit year or all accumulated rewards are lost! A member is eligible to earn rewards again the next year.   Benefit Threshold $750 Dental benefits received for the year cannot exceed this amount Annual Carryover Amount $250 Ameritas Rewards amount is added to the following year's maximum Annual PPO Bonus $150 Additional bonus is earned if the member sees a network provider Maximum Carryover Unlimited Maximum possible accumulation for Dental Rewards and PPO Bonus combined The High Plan includes a plan enhancement called Ameritas Rewards! This feature allows members to utilize some of their unused annual dental maximum in one year to carry over into the next year. Here is how it works. . . . If a person uses $750 or less in dental benefits in one year, they can carry over $250 to add to the following year’s maximum dental benefit. If a PPO provider was used, an additional $150 can be carried over to the following year. Let’s do the math. The High plan includes a $1500 maximum benefit per person. If less than $750 is used, and the person carries over $250 to the following year, their maximum benefit available the next year is $1750. An additional $150 can be carried over if a PPO provider was used, which would make the person’s maximum benefit $1900. The covered person can continue carrying over a portion of their maximum year after year. There is no limit to the amount that can be accumulated. For covered children, a higher annual dental maximum benefit may not be needed. However Ameritas Rewards can be used for orthodontic programs. If a covered child uses less than $750 of their annual dental maximum, rather than carrying over their unused dental maximum for a higher dental maximum the next year, the covered child can carryover up to $100 to be for additional orthodontia coverage. Remember that the covered person must submit at least one claim during the benefit, or the carryover amount is lost, and the person begins to earn rewards again the next year.

Low Plan Highlight Type 1 - Preventive procedures 80% (exams, cleanings, x-rays, child fluoride, etc.) Type 2 - Basic procedures 70% % (extractions, fillings, sealants, root canals, treatment of gum disease, oral surgery, etc.) Type 3 - Major procedures (not covered under this plan) Orthodontia (not covered under this plan) Under the Low plan, Type 1 Preventive procedures, such as exams, cleanings, and fluoride are considered at 80% of U&C. Type 2 Basic procedures like extractions, filings, sealants, treatment of gum disease, and oral surgery are considered at 70% of the maximum plan allowance. Under this plan, there is no Major or Orthodontic benefits. Like the high plan, you will note that the coinsurance levels shown are reimbursed based on “U&C” or the “maximum plan allowance” depending on the procedure type. Type 1 Preventive procedures are reimbursed based on the 90th U&C for the dentist’s zip code, meaning the 9 out of 10 dentist’s charges will fall within the amount Ameritas allows for Preventive procedures. Type 2 Basic are reimbursed on the Maximum Plan Allowance which is established according to the median dentist charges in the zip code where serves are provided.

Low Plan Highlight Deductible Maximum Type 1 Procedures $10 per visit Type 2 Procedures $50 Per Calendar Year Maximum deductible: three (3) family members Maximum Annual Maximum Per Member $750 There is no deductible for Preventive procedures on the Low Plan. If you or a covered dependent has a procedure related to Basic services, a $50 deductible will be applied. When three family members have satisfied their deductible, no further deductible is taken for the other family members for the rest of that year. The dental maximum benefit on the Low plan for each enrolled person is $750 every calendar year.

Low Plan Highlight New Plan Feature. . . . Dental Rewards! Utilize unused dental maximum to carryover towards dental benefits Accumulate up to $500 to carryover Must submit dental claim during a benefit year or all accumulated rewards are lost! A member is eligible to earn rewards again the next year. Benefit Threshold $250 Dental benefits received for the year cannot exceed this amount Annual Carryover Amount $125 Ameritas Rewards amount is added to the following year's maximum Annual PPO Bonus $50 Additional bonus is earned if the member sees a network provider Maximum Carryover $500 Maximum possible accumulation for Dental Rewards and PPO Bonus combined The Low Plan includes a plan enhancement called Dental Rewards! This feature allows members to utilize some of their unused annual dental maximum in one year to carry over into the next year. Here is how it works. . . . If an enrolled person uses $250 or less in dental benefits in one year, they can carry over $125 to add to the following year’s maximum benefit. If a PPO provider was used, an additional $50 can be carried over to the following year. Let’s do the math. The Low plan includes a $750 maximum benefit per person. If less than $250 is used, and the person carries over $125 to the following year, their maximum benefit available the next year is $875. An additional $50 can be carried over if a PPO provider was used, which would make the person’s maximum benefit $925. That person can keep carrying over a portion of their maximum until the carryover amount totals $500. Remember that the covered person must submit at least one claim during the benefit, or the carryover amount is lost, and the person begins to earn rewards again the next year.

PPO available under both plans Freedom to use any licensed dentist Coverage is the same whether you go in network or out of network A great feature about both the High and the Low plans is that you have access to Ameritas’ PPO network. Do you have to use a PPO provider? No. Under both the High and Low Plans, the member and their covered dependents have the choice to utilize any licensed dental provider. There is no difference in coinsurance, deductible or maximums for using an out of network provider. From the dentist’s perspective, both network and out of network providers have the same access to Ameritas’ provider service, including access to benefits, claims submittal can be via mail, fax, or electronic submittal, submitting pretreatment estimates and receiving payment directly. The difference is that out of network providers have not agreed to offer a PPO discount. So, often times, a member will experience lower out of pocket expenses when visiting a PPO network provider because of contracted fees. In addition to the potential savings, members can be assured that the Ameritas PPO providers have gone through a stringent credentialing and quality assurance process. And PPO providers provide added services such as filing claims on behalf of the member.

Filing a claim is easy! PPO Providers will submit the claims for you! You or your out-of-network provider may file the claim via mail, fax or email Filing claims is easy! If a PPO dentist is used, the provider will file the claim for you. If you see an out of network provider, filing claims is still easy. Simply complete the top portion of the claim form with your name and contact information then attach the bill or summary of services from the dentist. Some dentist’s even provide a generic claim form which we accept as well. You can mail the claim or use fax or email. Our claim processing is very fast and typically averages less than 10 days to process.

Questions about the dental plans or a claim? Toll free 800-487-5553 Available 7:00 a.m. CST – 12:00 midnight Monday – Thursday and 7:00 a.m. CST – 6:30 p.m. on Friday. OR go online for Frequently Asked Questions and more at: www.ameritas.com/group/olbc/egyptianschooltrust If you have questions about the plans or a specific claim, please call our toll free number. If you visit our website, you will find forms, benefit highlights, Frequently Asked Questions, and more!

Thank you! Thank you for taking the time to view this dental and vision benefit presentation. Ameritas appreciates this opportunity to be of service.