Iowa State University

Inside Iowa State
Nov. 1, 1996

Two dental options available

by Linda Charles
Faculty and P&S staff will be able to choose from two dental options under the new benefits program that is scheduled to go into effect in February 1997. The basic plan offers coverage similar to what ISU employees currently have, while the comprehensive plan allows for additional coverage. Following are answers to some frequently asked questions about the new plans.

What's the difference between the two plans?
Both plans pay 100 percent of diagnostic and preventive services, such as check-ups, cleanings and X-rays. The basic plan pays 50 percent for basic restorative services, such as fillings, simple extractions, space maintainers and root canal work. The comprehensive plan pays 80 percent of these costs. Both plans pay 50 percent of major restorative work, such as inlays, onlays and crowns. Orthodontic work is covered only by the comprehensive plan, which pays 50 percent up to a lifetime limit of $1,500 per patient. The comprehensive plan also pays 50 percent of restorative services, such as bridges and dentures, which are not covered by the basic plan.

Who is the insurance carrier for the plans?
Delta Dental was chosen as the insurance carrier because its extensive network of member dentists allows it to offer coverage at a lower cost than other carriers. Most Ames dentists are in the network. The network also extends throughout the state.

What if my dentist isn't a member of the Delta Dental network?
You may choose whatever dentist you want and still receive coverage. However, Delta Dental payments will be based on the rates the member dentists charge. For example, if a non- member dentist charges more for a filling than the member dentists charge, the patient must make up the difference.

What is the maximum that the plans will pay for dental care in a year?
The basic plan's maximum annual pay-out is $750, a $250 increase over the current coverage. The maximum for the comprehensive plan is $1,500. In addition, the comprehensive plan provides a $1,500 per person lifetime coverage for orthodontia.

If I choose one plan and later decide I want the other, can I switch?
You can switch from the basic plan to the comprehensive plan during regular annual enrollment periods. However, you must be enrolled in the comprehensive plan for at least three years before you can switch back to the basic plan. This requirement helps recoup the costs of those in the comprehensive plan who require extensive work, such as braces. While Delta Dental is the claims payer, Iowa State will be "self insured," which means that dental claims are paid out of a dental account funded by faculty, P&S staff, supervisory merit staff and the university.

How much will the plans cost?
It depends on what level of coverage you want. The university will provide a $13 per month credit for dental coverage. The following chart shows the monthly premium for employees once that $13 credit has been applied (note, all premiums are in pre-tax dollars):

Basic Plan Comp. Plan
Employee only $ 0 $ 8
Employee + spouse $17 $37
Employee + children $20 $42
Family $24 $48

What if I don't want dental insurance?
You may opt out of dental insurance and apply the $13 credit to other benefit options.

Where do I get more information about the dental plan?
You can access information about the new benefits program on the Web through the Iowa State homepage -- Faculty and Staff Information. (The lists of network providers for health care and dental plans will be on line soon.) You also can attend one of several information meetings to help explain the new benefits program. You do not have to preregister for the meetings, which are scheduled on:

When will I sign up for the new benefits program?
Around the middle of November, you will receive an enrollment packet with detailed information about the benefits program and a workbook to help you complete the enrollment form. You may sign up anytime after you've received the packet. The enrollment period ends Dec. 6. Your enrollment packets will allow paper or electronic enrollment. You will fill out the enrollment form and either send it to the Human Resource Services Benefits Office or use it as the guide for electronic enrollment on the Web.

What happens if I don't complete an enrollment plan?
You will be given a set of default coverages that are similar to the coverages you currently have. For example, if you currently elect family dental coverage, your default coverage will be family coverage under the basic dental plan.

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Revised 11/01/96