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Preferred Dental Program
Auburn University has a self insured group dental program for full-time University employees with
Blue Cross/Blue Shield of Alabama acting as an administrator for the processing of claims. The dental plan contains two options from which to choose. A brief summary of the two plans appears below. A booklet is available to explain the benefits in detail. Participation in the plan is optional.
Eligibility
Active full-time non-student employees are eligible if the most recent appointment period is continuous for a minimum of one year (nine or twelve months as appropriate to the appointment).
Enrollment
Participation in the program is optional . An employee/dependent who is eligible to participate must elect coverage within 30 days of date of employment or eligibility or during the open enrollment in November of each year. Once you have elected to enroll in the plan you cannot change or revoke this election unless there is a change in family status (e.g. marriage, divorce, childbirth, or death of spouse or dependent). All employees who enroll in one of the dental plans will make a commitment to be in the program for at least a two consecutive year period.
Basic Dental Plan
Maximum: there is no calendar year maximum
Deductible: there is no deductible
| Diagnostic and Preventive |
Payable at 100% of the Preferred Dental Schedule, with no deductible.
- Dental exams up to twice per benefit period.
- Dental X-ray exams:
- Full mouth x-rays, one set during any 36 consecutive months;
- Bitewing x-rays, up to twice per benefit period; and
- Other dental x-rays, used to diagnose a specific condition.
- Routine cleanings, twice per benefit period.
- Tooth sealants on teeth numbers 3, 14, 19, and 30, limited to one application per tooth each 48 months. Benefits are limited to a maximum payment of $20 per tooth. Limited to the first permanent molars of children through age 13.
- Fluoride treatment for children through age 18 twice per benefit period.
- Space maintainers (not made of precious metals) that replace prematurely lost teeth for children through age 18.
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If you do not use a Preferred Dentist, no benefits are available. You will be responsible for paying the dentist at the time services are rendered.
The program offers the following advantages:
- Preferred Dentists will file all claims and accept the Blue Cross payment as payment in full.
- Preferred Dentists have agreed to be reimbursed according to a fee schedule for each service.
Expanded Dental Plan
| BENEFITS | COVERAGE |
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| Deductible |
$25 deductible per member per calendar year; maximum of 3 deductibles per family each calendar year.
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| Maximum |
$1,000 per member each calendar year.
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| Diagnostic and Preventive |
Payable at 100% of the Preferred Dental Schedule, with no deductible.
- Dental exams up to twice per benefit period.
- Dental X-ray exams:
- Full mouth x-rays, one set during any 36 consecutive months;
- Bitewing x-rays, up to twice per benefit period; and
- Other dental x-rays, used to diagnose a specific condition.
- Routine cleanings, twice per benefit period.
- Tooth sealants on teeth numbers 3, 14, 19, and 30, limited to one application per tooth each 48 months. Benefits are limited to a maximum payment of $20 per tooth. Limited to the first permanent molars of children through age 13.
- Fluoride treatment for children through age 18 twice per benefit period.
- Space maintainers (not made of precious metals) that replace prematurely lost teeth for children through age 18.
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| Restorative Services |
Payable at 80% of the Preferred Dental Schedule, subject to the deductible.
- Fillings made of silver amalgam and synthetic tooth color materials.
- Simple tooth extractions.
- Direct pulp capping, removal of pulp and root canal treatment.
- Repairs to removable dentures.
- Emergency treatment for pain.
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| Prosthetic Services |
Payable at 80% of the Preferred Dental Schedule, subject to the deductible.
- Full or partial dentures.
- Fixed or removable bridges
- Inlays, onlays, or crowns to restore diseased or accidentally broken teeth , if less expensive fillings are not adequate.
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| Supplemental Services |
Payable at 80% of the Preferred Dental Schedule, subject to the deductible.
- Oral surgery to treat fractures and dislocations of the jaw, to diagnose and treat mouth cysts and abscesses, and for tooth extractions and impacted teeth.
- General anesthesia given for oral or dental surgery. This means drugs injected or inhaled for relaxation or to lessen pain, or to make unconscious, but not analgesics, drugs given by local infiltration, or nitrous oxide.
- Treatment of the root tip of the tooth including its removal.
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The Dental Network offers the following advantages:
- Network Dentists will file all claims and accept the Blue Cross payment as payment in full (after any deductible and coinsurance you owe).
- Preferred Dentists have agreed to accept our fee schedule as payment in full for covered services (after deductible and coinsurance). The fee schedule offers average savings of approximately 20% off billed charges.
- Services received outside Alabama will continue to be paid according to the UCR amount.
- The categories of dental services covered, level of coverage for each category, and the deductible and maximum amounts will be the same for network and non-network dentists.
- Payment for services provided by dentists outside the network in Alabama will also be made according to the Network Dentist fee schedule amount.
- If you do not use a Network Dentist, Blue Cross will pay you the Network Dentist fee schedule amount for covered services received. You may be responsible for the difference between the Blue Cross payment and the dentist's charge (plus any deductible and coinsurance). You may also have to file the claim if your dentist's office will not.
Dental Premiums 1-1-2008
| | Basic Plan | Expanded Plan |
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Biweekly |
12-month |
9-month |
Biweekly |
12-month |
9-month |
| Individual |
4.60 |
10.00 |
6.67 |
9.44 |
20.40 |
13.62 |
| Family |
15.25 |
33.00 |
22.00 |
30.60 |
66.30 |
44.22 |
All premium deductions are on a pre-tax basis.
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