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Dental Benefits Summary
Dental Benefits
The State Employee Group Dental Program is available to full-time State employees and their eligible dependents. New employees may enroll by completing a NJ State Dental Benefits Application during the first sixty days of employment. If you do not enroll when first eligible, you have the option to enroll each year during the annual open enrollment period. Open Enrollment is normally held in the October, with coverage effective the following January. If you do not enroll because of other dental coverage and you lose that coverage, you can be enrolled within 60 days of the loss of coverage.
Employees or dependents cannot be covered under more than one New Jersey State dental plan.
You have a choice between two types of dental plans:
- The Dental Expense Plan
- A Dental Plan Organization (DPO)
Dental Expense Plan
The Dental Expense Plan is a traditional indemnity- type plan administered by Aetna Dental. The plan allows you to choose any licensed dentist for your dental care. There is a deductible to satisfy for some services and some services are eligible only up to a limited amount. The annual plan deductible is $50 per person; $150 per family. The deductible does not apply to diagnostic, preventive, and orthodontic services. After you satisfy the annual deductible you are reimbursed a percentage of the reasonable and customary charges for services that are covered under the plan.
Dental Plan Organizations
The Dental Plan Organizations (DPOs) are companies that contract with a network of providers for dental services. There are several DPOs to choose from in the State Group Dental Program. A list of participating DPOs follows:
- Aetna DMO
- Atlantic Southern Dental (Benecare)
- Cigna Dental Health
- Community Dental Associates
- Horizon Dental Choice
- International Health Care
You must use providers participating with the DPO you select to receive coverage. Be sure you confirm that the dentist or dental facility you select is taking new patients and participates with the State program since DPOs also service other organizations. To review the various dental plans click on the link http://www.state.nj.us/treasury/pensions/shbp.htm. To obtain a quick reference comparison chart, click on the link http://www.state.nj.us/treasury/pensions/fact37.htm.
How to Apply for Dental Insurance Benefits
To apply for dental insurance benefits complete the Dental Insurance Enrollment Form or call the office of Human Resources at 2283 to obtain more information.
