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Insurance Benefits Related Areas
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Group Dental Insurance Group dental insurance is provided to all regular, full-time employees through CIGNA. Coverage is not provided to regular, part-time or seasonal employees. Retirees may continue coverage but only to the extent provided for under COBRA. Premiums for employee coverage are paid by the City. Employees may elect dependent coverage and are responsible for the cost of dependent coverage. The effective date of coverage for eligible employees and their dependents, if elected, is 30 days and coverage terminates the last date of the employee's employment with the City. The type of coverage provided is an Indemnity Plan. The plan provides coverage for preventative, basic, and major procedures. Orthodontia coverage is also available for dependent children under the age of 19. You may link to the Schedule of Benefits below. Deductible The deductible for each participant shall be fifty dollars ($50) annually for Basic and Major Services. The deductible shall be deemed satisfied for the entire family once the covered persons in a family have incurred a total of one hundred fifty dollars ($150) of eligible charges which may be applied towards the annual deductible for the calendar year. Maximum Annual Benefit The maximum benefit for each participant shall be one thousand two hundred fifty dollars ($1,250) annually for Preventative, Basic and Major Services. The maximum annual benefit is the maximum amount payable for all eligible charges incurred in a calendar year for a person’s dental care. Orthodontic Maximum Lifetime Benefit The maximum lifetime benefit for each covered participant who is age 19 or less on the date the Orthodontic procedure begins shall be one thousand dollars ($1,000) for Orthodontic services. Waiting Period The waiting period for Major services shall be deemed satisfied after one year for covered participants. The waiting period for Orthodontic services shall be deemed satisfied after two years for covered participants. Pre-determination of Dental Benefits Pre-determination of Benefits is recommended if a proposed course of treatment is expected to involve charges of three hundred dollars ($300) or more. Pre-determination of benefits is a system that allows a person and that person’s Dentist to know, in advance, what estimated benefits would be payable for a proposed course of dental treatment. A Summary of Benefits as well as provider booklets are available in the Human Resources Department. Disclaimer: The information provided herein is not meant to create a warranty or right, expressed or implied, to benefits and is provided for informational purposes only. The master contracts and/or plan documents are controlling in the event of errors or discrepancies. |
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