2011 Benefits Open Enrollment
Dental Coverage
Instructions and Information for
Completing Your Personal Enrollment
These instructions will assist you in completing your Personal Enrollment for The University of Iowa Benefits Program.
Due to a change in law, dependents may now be covered up to age 26, regardless of student status.
There are tax ramifications to consider
when covering students over age 26.
More information is here: http://www.uiowa.edu/hr/benefits/adult_child_enhance.pdf
Your flexible credits include a University contribution toward the cost of health and dental insurance for permanent University faculty, professional and scientific staff, and supervisory exempt merit staff holding a 50% time or greater appointment.
COVERAGE
Description and comparison of plans. Enrollment in the dental plan is optional. For no coverage, select option number “90.” If you want dental coverage, you must select from the dental programs shown. Once coverage is selected, enter that number on the line labeled “Option Code.”
Coverage is provided through Delta Dental of Iowa. Two plans are available: Dental I & Dental II.
PART A Dental Benefits (Preventative Maintenance Care)
Benefit |
Dental I |
Dental II |
|
|---|---|---|---|
Annual Deductible (Per Member) |
None |
None |
|
| Coinsurance | 0% |
0% |
|
| Maximum Annual Benefit (Per Member) |
None |
None |
|
Part A dental benefits include:
- Routine examination and teeth cleaning
PART B Dental Benefits (Restorative Care, Dental Prosthesis, and Surgical Care)
Benefit |
Dental I |
Dental II |
|---|---|---|
Annual Deductible (Per Member) |
None |
None |
| Coinsurance | 50% |
20% |
| Maximum Annual Benefit (Per Member) |
$750 |
Part B dental benefits include:
- Regular cavity fillings
- Oral surgery
- Emergency treatment for relief of pain
- Crowns
- Non surgical treatment for gum disease
- Root canal
- Bridges, partial and complete dentures
PART C Dental Benefits (Orthodontic Care)
Benefit |
Dental I |
Dental II |
|---|---|---|
Annual Deductible (Per Member) |
$50 |
$50 |
| Coinsurance | 80% |
70% |
| Maximum Annual Benefit (Per Member) |
$500 |
Part C dental benefits include:
- Treatment necessary for the proper alignment of teeth
- Orthodontic benefits paid quarterly
**$1,500 all covered services per member combined with Part B and C.
DENTAL COVERAGE RATES
Dental Coverage |
Employee Only | Employee and
Spouse |
Employee and
Children |
Employee and
Family |
|---|---|---|---|---|
Dental
I |
$29.00 |
$56.00 |
$75.00 |
$93.00 |
| UI contribution | $29.00 |
$45.00 |
$60.00 |
$75.00 |
Employee Cost |
$0.00 |
$11.00 |
$15.00 |
$18.00 |
Dental
II |
$ 49.00 |
$ 95.00 |
$ 100.00 |
$ 129.00 |
UI contribution |
$49.00 |
$76.00 |
$80.00 |
$104.00 |
Employee Cost |
$0.00 |
$19.00 |
$20.00 |
$25.00 |
If you have questions or concerns regarding the enrollment process, please contact:
University Benefits
120-40 USBEmail: benefits@uiowa.edu
Web Site: www.uiowa.edu/hr/benefits
Phone: 319-335-2676 or
877-830-4001 (toll free)Fax: 319-335-2776