How many times a year can I have my teeth cleaned?
The CCT dental plan allows for two (2) cleanings per calendar year separated by 6 months per fiscal year (July 01 – June 30).
Does the CCT dental plan cover orthodontics (braces)?
Orthodontia benefits are provided for active orthodontic treatment for children who are banded by age seventeen (17). Benefits are subject to the deductible and 50% coinsurance up to a maximum payable per lifetime of $2,500. Orthodontic benefit limitations include no coverage for treatment which commenced before the date the Plan member became eligible for benefits.
Is there a limit on how much the plan will pay for dental services?
Yes. The plan will pay up to $2,000 per person per fiscal year for in-network dental services and up to $2,500 per lifetime for orthodontic services for children.
What does “Usual, Customary and Reasonable (UCR)” mean?
This is the average cost a dentist charges for services in a given geographical area. All dental benefits are based upon UCR.
Can I receive benefits for dental care obtained outside of the United States?
You can visit any licensed dentist anywhere in the world for your dental care and benefit will be payable under the CCT dental plan. Prior to receiving dental care out-of-country it is recommended that you contact the Customer Service Department at Ameritas to request the information needed to process out-of-country dental billings. Typically, out-of-country claims must be submitted in English with American currency and include ADA codes.
What qualifies as a dental emergency?
Dental services that are immediately required to relieve pain, swelling or bleeding, or required to avoid jeopardizing the patient’s health qualifies as a dental emergency.
Is there a network of dental providers that I must use in order to receive dental benefits?
No although Ameritas does offer a dental PPO network for your use. There is also a greater percentage (%) of benefits paid if a PPO dentist is used and the plan year benefit is $2,000 for a PPO dentist and $1,500 for a non-PPO provider. Please note that dentists who are not in the Ameritas PPO network can balance bill patients for services excluded as a result of contracted rates and/or UCR. By visiting an Ameritas PPO dentist you will likely save money on your out of pocket expense.
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No matter your position – CEO, Superintendent, City Manager, HR Director, Director of Finance, or Administrative Assistant – understanding employee benefits can be overwhelming. Health Care Reform has drastically changed the landscape of employee benefit programs, and continues to do so. Staying abreast of ever-changing legislation, focusing on corporate compliance and continuing to educate employees on their benefits package is no easy task. ECA partners with our clients as an extension of staff to give objective advice, through transparent policies and comprehensive education.
|BENEFIT DESCRIPTION||AMOUNT PAYABLE BY PLAN|
|Annual Deductible (Jan-Dec)||$50 per Person/ $150 per Family||$100 per Person/$300 per Family|
|Annual Benefit Maximum (Jan – Dec)||$2,000 per Person||$1,500 per Person|
|Preventative Care||100% – no deductible||80% – no deductible|
|Orthodontics (For children banded by age 17)||50%*||50%*|
|Lifetime Orthodontic Maximum||$2,500 per Person||$2,500 per Person|
* Subject to Deductible
For more detailed coverage information, please contact your benefits department.
NOTE: If you use a non-preferred provider, the dentist can balance bill you for services outside the contracted amount payable.