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Eligible Categories: Administrative,
Executive, Full-time Regular Faculty, Hourly, Professional, and Regular Staff.
As a condition of participation, all employees
must enroll in the Group Health Insurance Program to qualify for Dental Insurance. All
eligible categories may participate in the dental insurance program currently offered
through Blue Cross/Blue Shield. Benefits are provided for preventive procedures (routine
cleaning and exams), basic procedures (fillings and extractions), and major procedures
(crowns and dentures).
Orthodontic benefits are provided for children
under 19 years of age.
The University and the employee share the cost
for the dental program. The premium can be payroll deducted on a pre-tax basis.
Dependent Dental Coverage - Dependents of
eligible employees may participate in the Group Insurance according to the terms and
conditions imposed by the Health Insurance Board of trustees and/or the carrier. Employees
must provide documentation of dependent eligibility upon request.
Schedule of Benefits - Subject to the
exclusions, conditions, and limitations of the coverage, a covered person is entitled to
benefits for Dental Services described below during a Benefit period, subject to the
Deductible, when applicable.
| BENEFIT PERIOD |
Calendar Year |
| PROGRAM DEDUCTIBLE |
$25 per person per Benefit Period |
| FAMILY DEDUCTIBLE |
$100 must be satisfied by Covered
Persons under the same Family Coverage in each Benefit Period. However, no family member
will contribute more than the individual program Deductible amount. |
| COINSURANCE |
0% of the Covered Expense Incurred
for charges made by a Dentist up to the amount listed in the Dental Services Schedule. |
| COVERED DENTAL SERVICES |
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| Preventive Services |
100% up to the scheduled maximum
benefit |
| Basic Restorative Services |
100% up to the scheduled maximum
benefit |
| Major Restorative Services |
100% up to the scheduled maximum
benefit |
| Orthodontic Services |
100% up to the scheduled maximum
benefit |
| BENEFIT PERIOD MAXIMUM FOR ALL
PREVENTIVE, BASIC AND MAJOR SERVICES |
$1,000 per individual per Benefit
Period |
| ORTHODONTIC SERVICES LIFETIME
MAXIMUM |
$1,000 per eligible Covered Person*
per lifetime |
*Orthodontic benefits are limited to
Dependent children under the age of 19.
For more information, refer to your BC/BS
Group Medical and Dental Benefits Booklet, or contact your Benefits Representative (desserie.smith@uvi.edu).
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