The University Record, September 3, 1996

New dental plan goes into effect Jan. 1

All faculty, staff, retirees and spouses of deceased retirees will participate in a new dental plan beginning Jan. 1, 1997. On that date, Metropolitan Life Insurance Company (MetLife) will replace United of Omaha as the administrator of the University dental plan.

The new plan will have three options: Option I will offer basic coverage usually at no cost to its members; Option II will be a preferred provider organization (PPO) offering increased coverage at a minimum cost to members, but restricting the choice of dentist to a provider directory; and Option III will be a dentist of their choice. Members choosing Option III will experience higher out-of-pocket costs and higher premiums than those of Option II.

Faculty and staff members who are eligible for flexible benefits can choose coverage in all three options. Bargained-for staff, retirees and spouses of deceased retirees will be enrolled in Option I.

 

Description of the Options

Option I: This option usually pays the full usual and customary cost for preventive services. Additionally, it has been modestly improved to cover more of the expenses resulting from frequently performed services, such as fillings and crowns. However, Option I is designed to be a basic plan and, as such, covers only a portion of the total charges for more extensive care.

Option II: This is a managed care option in which participants have a choice of dentists from a provider directory or network. Benefits are significantly reduced when the participant chooses a dentist who is not in the network. With a participating dentist, Option II provides full coverage for preventive care and basic services, lower out-of-pocket expenses for major and orthodontic services, and the convenience of obtaining benefits without submitting any claim forms.

Option III: This option provides the same level of benefits provided on an in-network basis in Option II, but without restrictions on the choice of a dentists. Out-of-pocket expenses will be higher than in Option II and participants may be required to pay the dentist and submit a claim form.

 

Transition from one plan to another

Transition from the current plan to the new option will not be noticeable to participants in the Dental Assistance Plan. They will not need to re-enroll themselves or their dependents because their entire contract will automatically be transferred into Option I.

Flex-eligible faculty and staff who currently participate in the Mutually Preferred Dental Plan can allow their contracts to be automatically transferred into Option II without any effort on their part. However, during Open Enrollment, Oct. 14-Nov. 1, flex-eligible participants can choose from any of the three new options. They can also choose "no coverage" and receive $5 per month cash back for 1997.

 

University contribution

The University pays for Option I dental coverage for all faculty, staff, retirees, and spouses of deceased retirees and their covered dependents at no cost after one year of continuous service. Flex-eligible participants with one year of continuous service will receive the same contribution toward the cost of the other options, but because Options II and III offer additional coverage, there will be a deduction from the participant's paycheck.

 

Lock-in periods

The two-year lock-in periods, currently required of participants in the Mutually Preferred Dental Plan, will be replaced on Dec. 31, 1996, with a one-year lock-in. This means that all members of the Mutually Preferred Dental Plan will be free to choose from the new options during Open Enrollment.

 

Faculty and staff members who are considering allowing their membership in the Mutually Preferred Dental Plan to automatically transfer to Option II should check to see if their dentist joined the MetLife network, since there is a one-year lock-in period. A current list of providers in a designated zip code can be obtained from MetLife. The number to call is 1-800-474-7371.

A further description of the MetLife options will be contained in the Open Enrollment materials that you will receive the first week in October. Flex-eligible faculty and staff also received a newsletter describing the new plan during July.