Section: Personnel
Policy Number: 4-69
Policy Name: DENTAL PROGRAM
Date: 1997 Revisions: May 2, 2008

POLICY

The University provides dental insurance for eligible full-time and part-time employees and their families. This plan is a component of the flexible benefits program, with options as follows:

  • employee only,
  • employee & spouse/same-sex domestic partner, and
  • employee, spouse/same-sex domestic partner and dependent children (up to age 21 or age 24 if full-time students).

The University pays the entire monthly premium for full-time employees and eligible family members enrolled in the program. Part-time employees who are scheduled to work less than 75% time (and 50% or more time) receive a pro-rated UD contribution and pay the remainder of the cost through pre-tax payroll deductions.

  • SUMMARY OF COVERED SERVICES

    • TYPE "A" EXPENSES - Diagnostic and Preventive Care (Examples: cleaning, x-rays, fluoride treatment, etc.)

      1. PLAN COVERAGE - 100% of reasonable and customary fees

    • TYPE "B" EXPENSES - Minor Restorative Care (Examples: fillings, extractions, surgery, periodontal/endodontic treatment, etc.)

      1. PLAN COVERAGE - 80% of reasonable and customary fees

    • TYPE "C" EXPENSES - Prosthodontics and Major Restorative Care (Examples: initial fixed bridgework, initial removable dentures, inlays, onlays, crowns, gold fillings, repair or recementing of bridgework, dentures, crowns, inlays, etc.)

      1. PLAN COVERAGE - 50% of reasonable and customary fees

    • TYPE " D" EXPENSES - Orthodontics (Examples: orthodontic diagnostics, surgical therapy, appliance therapy, etc.)

      1. PLAN COVERAGE - 50% of reasonable and customary fees

  • DEDUCTIBLES

    "A" Expenses None
    "B" Expenses $25/person or $75/family
    "C" Expenses $25/person or $75/family
    "D" Expenses None


  • MAXIMUMS

    "A"/ "B"/"C" Expenses $1,750 Annual Maximum (per person)
    "D" Expenses $1,750 Lifetime Maximum (per person)


PROCEDURE

Individual takes claim form to dental provider who submits it to MetLife for payment. It is recommended that providers also submit forms for predetermination of benefits in advance if a claim exceeds $100 in expenses.

You may access MetLife's home page on the World Wide Web.

Submitted by: Benefits Services