||Fringe Benefits: Dental Insurance
||Date of Present Issue:||
||Date of Previous Issues:
07/84, 07/86, 03/87, 06/89, 09/89
- Eligibility for Group Coverage
All faculty bargaining unit members, full-time administrative/professional
employees and full-time hourly bargaining unit members (employed over
26 hours per week) are eligible to enroll in the group dental plan*.
Employees (and/or their spouses) reaching age 65, who elect to remain
in the group health insurance plan (see Section 4.3.2.A) will have dental
insurance continued under the same conditions as other employees during
the term of their employment.
New employees may enroll before the 26th of the month in which hired
or rehired for coverage effective on the first day of the following month.
New employees hired or rehired between the 26th and the last day of the
month may enroll at time of hire, but coverage will become effective
one month later. EXAMPLE: an employee hired between January 26 and February
25 will be covered March 1. An employee hired on February 26 will be
covered on April 1. Employees who fail to apply for group coverage at
the time of hire may sign up only during the yearly re-opening
period in November with coverage effective on December 1.
Newly hired, full-time faculty who have signed a letter of appointment
may complete enrollment procedures in the month prior to being initially
placed on payroll so that coverage will be effective on the first day
of the month in which they are to be placed on payroll. Usually this
will be September 1. Faculty may complete the enrollment process by mail
in the month preceding coverage, but the enrollment card must be received
in the Employee Relations Office by the 20th of the month in order for
coverage to become effective on the first.
A new employee who has been enrolled under a Blue Cross-Blue Shield
plan of any state in the United States may transfer membership to the
University group plan without interruption of coverage. Membership between
spouses may be transferred in the same or to another group without interruption
The University pays the basic rate of the one-person, two-person, or
family premium for dental insurance, Class I, II, and III coverage for
eligible full-time employees (employed over 26 hours per week), at 70%
payment of reasonable charges, with a $1,000 maximum benefit per contract
Effective September 1, 1992, faculty bargaining unit members and eligible
A/P employees will also be eligible for Class IV, orthodontic benefits
with a 50% co-pay and a lifetime maximum of $1,500.
Part-time members of the faculty bargaining unit may enroll in the group
plan, and will sign a payroll deduction form at the time of enrollment
to have the pro-rated premium deducted from their paychecks; or they
will sign a waiver card if already covered under another dental insurance
policy (i.e. spouse's) and do not wish to enroll in the University plan.
If payroll deductions are stopped by the enrollee, coverage will be automatically
Children reaching age 19 may continue on the family coverage through
the year in which they become 19. Reduced rider coverage may be provided
for a child past age 19, at the employee's expense, by completing a Family
Continuation Rider application form and a payroll deduction form for
payment of premiums, if the child is:
- Between nineteen (19) and twenty-five (25) years of age
- Legally residing with and dependent on the subscriber for more than
half of his or her support as defined by the U.S. Internal Revenue
The cost of the Family Continuation Riders is paid by the employee and
is deducted each month from the last paycheck of the month for coverage
for the following month. The cost of Family Continuation Riders for faculty
bargaining unit members and A/P employees is paid 100% by the University.
- Changes in Coverage
Any changes in coverage (i.e. birth, death, marriage, or divorce) must
be reported to the Employee Relations Office within 30 days of occurrence,
and reported to the underwriter on a Change of Record form. Forms are
available in the Employee Relations Office.
Failure by the subscriber to report these changes places liability for
loss of coverage, or additional costs, on the individual.
- Termination of University-Paid Coverage
University-paid coverage terminates on the last day of the same month
if employment terminates on or before the 15th of any month. University-paid
coverage will be continued to the last day of the following month if
employment terminates on or after the 16th of any month.
University-paid coverage for faculty members on academic year appointment
terminating at the end of the academic year (May) will be extended through
August 31 of their year of termination.
- Cash Payment and Election of Continuation of Coverage
- Cash payments may be accepted for employees on unpaid medical leave,
or on unpaid leave of absence of up to one year, if payment is made
prior to the 20th of the preceding month for each month of coverage.
- Beginning July 1, 1986, for non-union employees, and January 1, 1987,
for union employees, the option to continue coverage in the group is
available, with identical coverage, without proof of insurability,
under the same conditions as other group members, by paying the group
premium rate, for the following: (COBRA Law)
If elected by employees, for 18 months, if loss of coverage
is due to:
- reduction in work hours
- voluntary termination (quit or retire)
- lay-off due to economic reasons
- discharge for misconduct (other than gross misconduct)
If elected by dependents, for 36 months, for:
- surviving spouses and their children (deceased employee)
- children of deceased employees (i.e. single parent) and children
of deceased surviving spouses
- separated, divorced, or Medicare ineligible spouses, and affected
children of current employees
- children of current employees who would lose coverage because
of their age (i.e. FC and SD rider)
Election to remain in the group plan must be made within 60 days
of notification of the right to elect this option. Premiums must
be paid by the 20th of the prior month, for continuous coverage,
and retroactive payments made within 45 days of election of continuous
- Persons desiring to make cash payments should contact the Employee
Relations Office for assistance before making payment at the Cashier's
- Termination of Subscriber-Paid Coverage
The University will terminate Continuation Coverage prior to expiration
of 36- or 18-month optional period if:
- the dental plan provided to any employee is abolished
- the beneficiary fails to pay the premium
- the beneficiary becomes eligible for another dental plan upon re-employment,
remarriage, or attainment of medicare eligibility.
Forms are available in the Employee Relations Office.