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Dental
Insurance
The State offers the Blue Cross of Idaho Dental
plan to you and your eligible family members. Participation in
the plan is automatic for employees enrolled in one of the State's
medical plans. NOTE: Dental coverage is
available only if you participate in a State employee
medical plan - you cannot elect dental coverage without electing
medical.
Declining
Dependent Dental
Employees can decline dental
coverage for their dependents at any time. To do that, select "Self
only" in the Dental Enrollment section of the medical/dental enrollment
form.
Once you have
declined dependent dental coverage, you may only obtain it
during an open enrollment period.
Waiting Periods
Dental Plans
For all new dental
plan enrollees, there is a
12 month waiting
period for
major care (covered crowns, bridges, dentures, etc) and orthodontia
services. Please refer to the
Dental Plan contract for specific details.
Your time
enrolled in a prior dental plan cannot be credited against the
waiting period in the State's dental plan.
How the Blue Cross
Dental Plan Works
With this plan, you can use
any provider you want - but you may save money when you use providers who
belong to the Blue Cross of Idaho network of participating providers.
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In-Network Providers have negotiated with Blue
Cross of Idaho to provide plan participants with
services at the plan's Allowable Charges. That
means they will accept plan benefits plus your share of
the costs (any deductible, coinsurance or copayments) as
payment in full.
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Out-of-Network Providers may charge more than
the plan's Allowable Charges, which means you are
responsible for any amounts that exceed the Allowable
Charges plus any deductible and coinsurance amounts.
To locate
participating providers, refer to the Blue Cross of Idaho
participating provider directory located at
www.bcidaho.com
Summary of Dental Benefits (Blue Cross of Idaho)
|
Features & Covered
Costs |
Traditional Contracting Providers |
PPO Contracting Providers
|
| Annual Deductible |
$25 |
| Annual Maximum
Benefit |
$1,000 |
| Orthodontia Lifetime
Maximum for Eligible Dependent Children to age 19 (treatment must
begin prior to age 17) |
$1,000 |
| Orthodontia Waiting
Period |
New Enrollees:
12 months |
| Additional Waiting
Periods |
New Enrollees:
12 months for Crowns, Bridges, Dentures, and Dental Implants |
Preventive &
Diagnostic,
Exams, Cleanings, X-Rays |
BCI pays
80% of Maximum Allowance |
BCI pays
70% of Maximum Allowance after Deductible |
Other
Dental Services,
Fillings, Sealants, Occlusal Guards |
BCI pays 80% of Maximum Allowance after Deductible |
BCI pays 70% of Maximum Allowance after Deductible |
Basic Dental
Services,
Root Canals, Extractions, Periodontics, Osseous Surgery |
BCI pays
80% of Maximum Allowance after Deductible |
BCI pays
50% of Maximum Allowance after Deductible |
| Major
Dental Services, Crowns, Dentures, Bridges
after 12-month waiting period for new
enrollees |
BCI pays 50% of Maximum Allowance after Deductible |
BCI pays 50% of Maximum Allowance after Deductible |
| Dental Implants
after 12-month waiting
period for new enrollees |
$900 per tooth maximum lifetime
benefit (including crown). BCI pays 50% of Maximum Allowance
after Deductible |
| Orthodontic Services,
Only available for eligible dependent children prior to age 17 but to
age 19,
after 12-month waiting period for new enrollees |
$1000 lifetime benefit
BCI pays
50% of Maximum Allowance
|
Medical, Dental, and
Vision
You and the State share in
the monthly cost of these coverages. How much you'll pay depends on
which plan you choose and how many family members, including yourself, are
enrolled. If you've elected to participate in the
Premium Only Plan, your share of the monthly premium will be deducted
from your paycheck on a pre-tax basis.
FY2010
Monthly Premium Rates for Full-Time Employees (36 - 40 hours/week)**
Plan Type
|
Employee
Only
|
Employee +
Spouse
|
Employee +
Child
|
Employee + Children
|
Employee
+
Spouse &
Child |
Employee +
Spouse & Children |
|
Blue Cross Traditional
Plan |
$37.00 |
$94.00 |
$65.00 |
$86.00 |
$117.00 |
$131.00 |
|
Blue Cross PPO Plan |
$30.00 |
$77.00 |
$52.00 |
$71.00 |
$96.00 |
$109.00 |
| Blue Cross
High-Deductible Plan |
$24.00 |
$65.00 |
$43.00 |
$59.00 |
$81.00 |
$91.00 |
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Blue Cross Dental |
$7.75 |
$36.25 |
$30.50 |
$46.50 |
$51.75 |
$59.75 |
**Part-time
employees (less than 36 hours/week) will pay increased monthly premiums.
Rates can be found on the Group Insurance website at:
http://adm.idaho.gov/insurance/insurance.html
Please
refer to the
Employee Group Insurance
Handbook
or
http://adm.idaho.gov/insurance/contracts.htm
for more detailed information.
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