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State Dental Plan Insurance Education Part #3

State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

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Page 1: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

State Dental Plan

Insurance Education Part #3

Page 2: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

Features•Self-insured plan•Free to choose dentist - no network

•No pre-existing condition

BlueCross BlueShield of SC administers claims

State Dental Plan

Page 3: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

BlueCross BlueShield of SC administers claims

State Dental Plan

(cont.)

•Enrollment Within 31 days for new hires or Special eligibility situation Otherwise, every two years at open enrollment

•$1,000 annual maximum benefit

Page 4: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

BlueCross BlueShield of SC administers claims

State Dental Plan

(cont.)

•State Dental Plan ID cards (not personalized) Benefits administrators order from BCBS

Subscribers request cards from benefits administrator

Page 5: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

* $25 deductible for Classes 2 and 3

Class 1• Preventive

services• 100% of fee

schedule

Class 2*

• Basic services

• 80% of fee schedule

Class 4• Orthodontics (only

children under age 19; $1,000 lifetime maximum)

Classes of Coverage

Class 3*

• Prosthedontics• 50% of fee

schedule

State Dental Plan

Page 6: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

•Employee only•Employee/spouse•Employee/children•Full family

$ 0.00$ 7.64$13.72$21.34

Monthly Premiums

BlueCross BlueShield of SC administers claims

State Dental Plan

Page 7: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

Dental Plu$

Insurance Education Part #3

Page 8: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

Features•Must be enrolled in State Dental Plan (SDP)

•Must have same level of coverage as in SDP

•May enroll in or cancel coverage only during the open enrollment period (every two years)

BlueCross BlueShield of SC administers claims

Dental Plus

Page 9: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

• No additional deductibles, coinsurance or claims to file

Higher allowance for same services covered under SDP, except orthodontics

Combined annual maximum benefit for SDP and Dental Plus for services in Class 1, 2 and 3 $2,000 per covered person

(cont.)

BlueCross BlueShield of SC administers claims

Dental Plus

Page 10: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

•Subscribers/providers file claims to Blue Cross Blue Shield of SC

•BCBS processes claim under SDP first, then under

•Dental Plus•Personalized ID cards for Dental Plus subscribers are in employee’s name

(cont.)

BlueCross BlueShield of SC administers claims

Dental Plus

Page 11: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

• Order Dental Plus ID cards by visiting: www.southcarolinablues.com Go to “My Insurance Manager” Register to place order

(cont.)

BlueCross BlueShield of SC administers claims

Dental Plus

Page 12: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

Employees pay entire premium Pay premiums with pretax money under MoneyPlu$

Participating dentists list on BCBS Web site:

www.southcarolinablues.com

(cont.)

BlueCross BlueShield of SC administers claims

Dental Plus

Page 13: State Dental Plan Insurance Education Part #3. Features Self-insured plan Free to choose dentist - no network No pre-existing condition BlueCross BlueShield

Pay Dental Plus premiums in addition to State Dental Plan premiums

• Employee only $20.60• Employee/spouse $39.00• Employee/children $42.56• Full family $60.96

Monthly Premiums

Insurance Education Part #3

Dental Plus