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Dental Care Plans
Who is eligible for dental insurance coverage?AURA/NOAO - regular status staff scheduled to work at least 20 hours per weekAND Spouse - An employee's legal spouse. Children - Dependent children include natural, step, legally adopted children, or a child placed for adoption. Unmarried dependent children may be covered up to age 19 and up to age 25 if they are full-time students. Coverage terminates at the end of the month in which the 19th or 25th birthday occurs. (Dependent children incapable of self-sustaining employment because of a handicapped condition will be continued beyond the limiting age – see certificate of coverage for specifics.) What are my coverage options?You may select either employee + spouse, children or family coverage.How much does dental insurance coverage cost?Premium payments for dental insurance coverage are made bi-weekly by payroll deduction on a pre-tax basis.What plans are offered?AURA currently offer two plans to employees working in Tucson, Arizona and one plan to all other areas.Metropolitan Life Insurance Company (MetLife) all areas Employer's Dental Services (EDS) Arizona only When does dental insurance coverage begin?Company-sponsored dental insurance coverage begins the first day of the month following or coincident with the date of employment.How can I find out if my dentist is in the EDS or MetLife network?
EDS Dentist Search Click on the members link and under the member drop down menu click dentist search. What do I do if I get a bill from my dentist?If you are a member of MetLife, you should obtain a claim form from MetLife or the human resources office, complete the form and submit the completed form directly to MetLife.If you are member of EDS, you should contact EDS directly.
How do I change my dental plan coverage?Each year during Open Enrollment, you may elect to enroll in the dental plan or add coverage for a spouse or dependent child. Changes are effective January 1.At any other time a change may be made within 31 days from the date of a qualified change in family status. Examples of a qualified change in family status include: a birth, adoption, change in marital status, death of spouse or dependent, or change in spouse employment status. After initial employment or benefits eligibility, an individual may either enroll in a dental plan or add dependents only during Open Enrollment or within 31 days from a qualified change in family status. Those that do not enroll with MetLife during the initial eligibility period will be considered a late enrollee. Late enrollees are subject to a 6-24 month waiting period for services excluding preventive care. Please refer to the MetLife schedule of benefits for more information. When can my dependents be added to my dental plan?An employee may enroll his or her spouse and eligible dependent children within 31 days from the date of employment.Employees may also add coverage for a spouse or children within 31 calendar days from the date of a qualified change in family status (marriage, birth, adoption) or loss of previous coverage. Otherwise, coverage for dependents may be added during Open Enrollment with coverage effective January 1st of the next year. How long can my child be insured as my dependent?Unmarried dependent children may remain insured as dependents until his or her 19th birthday, and then until the end of the month in which his or her 25th birthday occurs if the dependent is a full-time student. Certification of a child's student status is required at age 19, and recertification is required annually thereafter. Children who cease to be eligible as dependents may continue coverage on their own by paying the full cost for up to 36 months under a federal law referred to as COBRA.Can I receive care from any dentist?Those enrolled in EDS should must receive care from one of the participating dentist in the EDS network and you must use the dental facility you have selected.Those enrolled in MetLife are free to select the dentist of your choice. However, if you choose a dentist who does not participate in the MetLife PDP, your out-of-pocket expenses may be more, since you will be responsible for any difference between the dentist's usual fee and the plan's payment. If you received services from a participating PDP dentist, you are only responsible for the difference between the PDP fee and the plan's payment. How do I change my dentist?Those enrolled in EDS should contact customer service at (800) 722-9772 or changes can also be made on the EDS web site (Changes received by the 24th of the month will be effective the first of the following month.)Those enrolled in MetLife can choose any dentist at any time. What happens to my insurance when I terminate employment?Persons leaving employment are entitled to continue the dental coverage for up to 18 months under the Consolidated Omnibus Budget Reconciliation Act (COBRA). Cost of coverage is borne fully by the employee. There is no company contribution toward COBRA coverage. Human Resources sends Notice of the COBRA Continuation option to employees.How can I contact a dental insurance company with a question, or to inquire about a claim?An individual may contact representatives of the applicable insurance company to ask a question, change his or her address, or inquire about a claim.
Who do I contact if I have additional questions?
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