• Six DPOs are available: Aetna DMO; BeneCare; Cigna DHMO; Community Dental Associates; Healthplex; and Horizon Dental Choice. Note: DPOs contract with a network of providers for dental services. When an employee or dependent uses a DPO dentist, diagnostic and preventive services are covered in full. Most other eligible expenses require a small copayment. Members must use a provider that participates with the DPO selected to receive coverage. Be sure to confirm that the dentist or dental facility selected is taking new patients and participates with the SHBP Employee Dental Plans, since DPOs also service other organizations.
• The Dental Expense Plan is a PPO plan that allows members to obtain services from any dentist; however, as a PPO, using an in-network provider will reduce an employee’s costs. After satisfying an annual deductible (no deductible for preventive services), members are reimbursed a percentage of the reasonable and customary charges for eligible services.
The employee cost for coverage is 50% of the actual dental plan premium; the cost varies depending on which dental plan an employee chooses; however, the rate for coverage under a DPO remains considerable less expensive than the Dental Expense Plan.
The month of October is the annual Open Enrollment Period. During Open Enrollment employees can make general changes (adding or deleting dependents, changing coverage levels, etc.) or enroll in a different dental plan. All changes made during Open Enrollment become effective on January 1st of the following year. Note: Employees must remain enrolled in a dental plan for a minimum of 12 months before they will be allowed to change plans. This means that an employee who was not enrolled in a dental plan as of Jan. 1, 2013 will not be permitted to change dental plans during the 2013-2014 Open Enrollment.