Dental Care Benefits
 
 
  1. Benefits
  2. Dental Rates
  1. 2009 Dental Benefit Summary
 
 

BENEFITS

 

As a regular full-time faculty or staff member, you may choose to enroll in the Penn State Dental Plan for yourself and for your eligible dependents. The Dental Plan is administered by United Concordia (UCCI), which offers dental care benefits through a nationwide network of qualified providers. As an alternative to UCCI participating providers, you may use any dental care specialist.

 
 
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DENTAL RATES

 
2009 RATES Total Cost Employer Monthly Employee Monthly Employee Biweekly
Employee $ 28.49 $ 22.79 $ 5.70 $ 2.63
Family $ 74.84 $ 55.38 $ 19.46 $ 8.98
 
 

2009 DENTAL BENEFITS SUMMARY

 
 

Through a new wellness-focused, preventive incentive, dental services considered diagnostic and preventive will not count toward a member’s annual $1000-per-member maximum. These services include cleanings, exams, and x-rays for all members, and fluoride treatments and sealants for dependent children. The preventive incentive provides additional buying power so that more dollars are available to use for services other than regular cleanings and exams. This comes to roughly $250 more per member per year, stretching the $1,000 yearly maximum.

 
 

* Deductibles are waived for services from network providers and percentages are applied to agreed reimbursement rates. Non-network reimbursements are based on the stated percentage of the maximum allowable charges.

 

**When appropriate, coverage for prescription fluoride treatment is available through your Penn State health plan. Coverage applies at the retail level from your local pharmacy as well as from your mail-order maintenance drug plan. Additional information is available in United Concordia's Adult Fluoride Treatment FAQs.

 

You may access a list of participating providers from the UCCI website. You can locate participating providers in Centre County from the Nittany Dental Network.

 

A predetermination of benefits permits a review of a proposed treatment in advance and allows for resolution of any questions before, rather than after, the work has been done. Additionally, both you and the dentist will know in advance, rather than after, the coverage and estimated benefit. A predetermination should be requested when the total charges will be $300 or more.

 

Benefit Category

Plan Pays *
Class I - Diagnostic/Preventive Services (excluded from annual program maximum)
Exams - two in any calendar year 100%
Cleanings - two in any calendar year
Bitewing X-rays - twice in any calendar year

Fluoride Treatments (to age 19)
Sealants - thru age 10 - 1st molars/age 15 - 2nd molars
Class II - Basic Services
Full mouth X-rays-once in any 36 consecutive months 80%
Palliative Emergency Treatment
Space Maintainers
Basic Restorative
Endodontics
Repair of Broken Dentures
Simple Extractions
Oral Surgery
General Anesthesia
Periodontics
Class III - Major Services
Inlays, Onlays, Crowns 60%
Prosthetics (Bridges, Dentures)
Implant related Services (limited to subscribers age 18 and over)
Implant prosthetic (crown) 60%
Inclusive of $1,000 annual program maximum  
Orthodontics (All subscribers to any age; lifetime annual maximum)
Diagnostic, Active, Retention Treatment 60%
Orthodontic Lifetime Maximum $1,500
Maximums/Deductibles
Annual Program Maximum (per covered member) $1,000
Program Deductible (per member/per family) $25.00/$50.00

* - Percentages are based on United Concordia Companies Maximum Allowable Charges (MAC). The Maximum Allowable Charge is an amount that UCCI has contracted with providers to accept as payment in full, less any deductibles and co-insurances. You can maximize your benefits by obtaining services through a participating United Concordia Provider (Advantage Network, or Nittany Dental Network provider in Centre County.

** - There is no program deductible when services are performed by an In-Network provider.
Unmarried Dependent Children covered to age 19/Unmarried Dependent Students covered to age 24.

This listing is a representative listing of covered services—please refer to your Certificate of Coverage and Implant Rider for a detailed description of benefits. Exclusions and limitations may apply.

 
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