NEISD DENTAL--2008-2009 Plan Year
Need
to make changes during Open Enrollment?
click
here
Monthly employee premiums for the 2008-2009 plan year are:
| Employee Only | $22.00 |
| Employee and Spouse | $58.00 |
| Employee and Children | $55.00 |
| Employee and Family | $69.00 |
Self-funded Plan
The NEISD Dental Plan is a self-funded program. This means that employee contributions are placed in a District fund and all dental claims and administrative fees for the Plan are paid from this fund. The District contracts with a third party administrator, Compbenefits, to administer our claims. Being self-funded provides the following advantages for employees:
- Benefits under the 2008-2009 dental plan year have increased, please refer
to the schedule of benefits below.
- Claims are paid locally by Compbenefits.
- The District has greater control over future cost
increases, plan design and quality of service.
- The District can provide benefits at a lower cost than a fully insured program because the portion of the premium charged by insurance companies for high operating costs and profit is eliminated.
What's New This Year?
- Adult orthodontia benefits have been added.
- Annual benefit maximums have increased to $1,000 for Year Two and $1,500 for year Three for all participants.
Coverage
Coverage in
this plan is set on a graduated scale. In other words, the longer you
participate in the plan the better the plan will pay. This is to encourage
continuous membership as well as regular dental care for you and your family.
It also protects your plan against adverse selection, which results in increased
premiums. The following is a summary of coverage available to you as a
member of the North East ISD Dental Plan. Please note that claims are
paid for necessary care and treatment of a covered person based on "usual
and customary
charges."
For more details, a brochure may be requested from your campus/department main
office.
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* Refer to your dental brochure for a detailed description of the types of procedures and the categories.
How To Make Family Status Changes outside of Open Enrollment
Current enrollees who do not have their dental premiums under the Cafeteria Plan and want to cancel coverage should complete the Dental Plan form and sign the section for Declination of Benefit. If your coverage is on the Cafeteria Plan, you must meet the guidelines for canceling coverage under the the Cafeteria Plan Section 125 you will also need to complete a new Cafeteria Plan Election form. See Cafeteria Plan bulletin for other opportunities to enroll or cancel dental coverage, or call the Employee Benefits Office for details.
If your child is a full-time student and at some point does not enroll full-time in either the fall or spring semesters, they will lose their eligibility. However, if at a later time they again become eligible, you can add them within thirty (31) days of their eligibility date; benefits would begin with year one (1). You may also continue their coverage through COBRA, without a break in coverage or loss of benefits. Contact Employee Benefits for additional information.
Are you paying for coverage for an ineligible dependent?
If you have provided dental benefits for a spouse or dependent child that is no longer eligible, please complete a new enrollment form with information on yourself and any other eligible dependents. Coverage for dependent children ends at age 19 unless they are a fulltime student. (Coverage may remain in effect until age 25 for fulltime students.)
Remember: Employee Benefits cannot make changes to your payroll deduction without your written authorization.
Enriched Vision Benefit
As an added value benefit to the NEISD Dental Program, participants will be able to access Preferred Vision Care for eyewear, frames, lenses, and other eyewear accessories, at a savings of up to 50% off retail prices.
Need to Contact Preferred Vision?
1-888-526-8000
Hearing Enhancement
Beltone offers
members a variety of services from hearing exams and evaluations to more than
75 models of hearing instruments.
- Free hearing exam for your and your family members
- 15% off the dispensers regular list price on hearing aid purchases
- Belcare follow up, customer
commitment honored at 2,000 Beltone Centers
Need to Contact Beltone?
1-800-BELTONE
compbenefits --Dental/Vision
1-800-342-5209
P.O. Box 8236
Chicago, Illinois 60680-8236
www.compbenefits.com