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Dental and Vision Insurance

Enrollment in dental insurance must be made within the first 31 days of employment.  

After initial enrollment, changes may only be made:

  • within 60 days of a special qualifying event if employee currently has coverage
  • during the "Annual Transfer Period" all eligible employees are allowed to add dental coverage

2019 Dental Insurance

Eligible employees can choose from two dental options:

  • Prepaid Plan
  • Dental Preferred Provider Organization

In 2019, the Prepaid Plan will be administered by Cigna and the DPPO will be administered by MetLife.

 

The Prepaid Plan provides services at predetermined copay amounts from a limited network of participating dentists and specialists.

  • To receive benefits, you must select a dentist from the Prepaid Plan list and notify Cigna of your selection. You can search for participating dentists on Cigna's website.
  • There are some areas in the state where the network dentists are not available. Be sure to carefully review the provider directory. Some dental offices may be closed to new enrollment.
  • You must use your selected dentist to receive benefits.
  • The plan provides services at predetermined member copay amounts (reduced fees) for dental treatments.
  • There are no deductibles to meet, no claims to file, no referrals, no waiting period and no annual dollar maximum. Pre-existing conditions are covered.

You can search for participating dentists on Cigna's 2019 Plan Information - select the Cigna Dental Care HMO network.

The Dental Preferred Provider Organization (DPPO) provides services with member coinsurance rates. Any dentist may be used to receive benefits, but member cost will be less if an in-network provider is used.

  • Use any dentist (receive maximum benefits when visiting an in-network MetLife DPPO provider).
  • Member pays coinsurance for covered services. Deductible applies for basic and major dental care only.
  • You or your dentist will file claims for covered services. Referrals are not required.
  • Some services (e.g. crowns, dentures) require a 6-month waiting period before benefits begin.
  • Other services (orthodontics, replacement of missing tooth) require a 12-month waiting period before benefits begin. There are some limitations and exclusions, (e.g. no benefit for cosmetic reasons, congenital malformations, diagnosis or treatment of TMJ.
  • You pay coinsurance for many covered services and your share is based on the "maximum allowable charge" (MAC) for a given service.
  • You will pay less out-of-pocket when seeking care from a network provider because network dentists and specialists typically agree to the allowable charge up front.
  • Out-of-network providers typically charge more than the allowable charge, resulting in higher costs for you.

You can search for participating dentists on MetLife's MYBenefits. Select the PDP network.


2019 Vision Insurance

Vision coverage is available to all state and higher education employees and dependents. You must pay 100 percent of the premium if you elect this coverage. Two options are available — a basic plan and an expanded plan. Both plans offer the same services, including:

  • Annual routine eye exam
  • Frames
  • Eyeglass lenses
  • Contact lenses
  • Discount on LASIK/refractive surgery

Additional Benefits

Davis Vision offers some additional benefits, based on the plan you choose, including:

  • Zero ($0.00) copay for single vision, bifocal, trifocal or lenticular lenses purchased at an in-network location.
  • Free pair of eyeglass frames from any Davis Vision’s “The Exclusive Collection”, which includes “Fashion, Designer and Premier” Selections under the in-network Expanded Plan.
  • Free pair of “Fashion Selection” eyeglass frames from Davis Vision’s “The Exclusive Collection” under the in-network Basic Plan. “Designer” and “Premier” Selections have $15 and $40 copays respectively.
  • Free pair of frames at Vision works retail locations.
  • 40% discount off retail under the in-network Expanded Plan and 30% discount off retail under the in-network Basic Plan for an additional pair of eyeglasses, except at Walmart, Sam’s Club or Costco locations.
  • 20% discount off retail cost of an additional pair of conventional or disposable contact lenses under the in-network Expanded Plan.
  • One year warranty for breakage of most eyeglasses.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Questions or Concerns?

For questions about Vision Insurance you can go to davisvision.com.

To review benefits for the plans, use these plan codes:

  • Basic Client Code: 8155
  • Expanded Client Code: 8156

You can also call Davis Vision at 800.208.6404:

  • Monday through Friday 7 am — 10 pm CST
  • Saturday 8 am — 3 pm CST
  • Sunday 11 am — 3 pm CST

Last Published: Aug 23, 2019