The Dental Plan is an optional group dental plan that provides coverage for preventive and many basic and major services. The plan is offered through Aetna.
The Dental Plan includes coverage for
- preventive and diagnostic care, such as routine checkups and cleanings;
- basic services, such as fillings;
- major services, such as prosthodontics and crowns; and
- orthodontic treatment for eligible dependent children.
Note: If you do not enroll in the Dental Plan within the first 30 days of initial eligibility or within 60 days of a qualifying life event, you generally must wait until the next annual enrollment or qualifying life event to enroll, and when you do enroll, there will be a 12-month waiting period for basic and major services, and a two-year waiting period for orthodontic treatment for children.
You are eligible for the Dental Plan if you are
- an active member with medical coverage under the Traditional Program;
- an active member offered medical coverage under the Affiliated Benefits Program (ABP) and your employer offers the Dental Plan to your employment classification;
- a disabled member under the Traditional Program or the ABP who is enrolled in the Dental Plan when your disabled status begins;* or
- a member of the Traditional Program participating under the transitional participation coverage and you enrolled at the time you began participating under that status.*
*If there is a break in coverage or dues are not submitted on time, your coverage will end.
What Network Options Are Available
There are two types of dental provider networks under the Dental Plan:
- dental maintenance organization (DMO)
- preferred provider organization (PPO)
Both DMOs and PPOs have network providers that have agreed to provide services for lower, negotiated fees. You can visit out-of-network providers if you are covered under the PPO.
The plan options that are available to you are determined by your home address ZIP code:
- dual option (DMO and PPO plans)
- only the PPO plan
- Passive PPO plan (offered if you live in an area without reasonable access to PPO providers; therefore, your benefits are not reduced if you see an out-of-network provider)
Coverage is available to eligible members and eligible family members at the following levels:
- member only
- member and covered partner
- member and children
- member and family
How To Enroll
You can enroll yourself and your eligible family members for dental coverage
- when you first enroll in the Benefits Plan;
- within 60 days of qualifying life event, such as a marriage or qualified domestic partnership, a change in your covered partner’s benefits, or the birth or adoption of a child; and
- when the Board offers an annual enrollment period (generally in the fall for coverage beginning January 1 of the following year).
You can enroll online through Benefits Connect, the Board’s secure benefits website, or by submitting the form that corresponds with the plan for which you are eligible.
Dues for dental benefits are submitted through your employing organization unless you are participating under a self-employed specialized ministry, transitional participation, or disability status. Dues vary based on the dental network through which you have coverage and the level of coverage you have.