SHBP Announces Boost to Dental Benefits

 

May 2016

 

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The Seafarers Health and Benefits Plan (SHBP) last month announced significant increases in dental benefits for SIU members and their dependents who are covered at the Core-Plus and Core benefit levels.

 

In her report for the April membership meetings and also in a recent participant letter, Seafarers Plans Administrator Maggie Bowen said the improved coverage takes effect May 1. The letter read in part, “Previously, the maximum dental benefit for employees and their dependents at the Core-Plus benefit level was $750 per calendar year, and the Plan had a schedule which specified the amount it would pay for each service. In addition, there was a $1,000 lifetime maximum for orthodontia.

 

“Beginning on May 1, the Core- Plus dental benefit is being increased to $2,000 per calendar year for each eligible person,” the letter continued. “The Plan will pay 100 percent of the first $500 of dental services. After that, if you use an in-Network provider, the Plan will pay 60 percent of the network-allowed amount for remaining services, up to the $2,000 annual maximum. If you use an out-of-network provider, the Plan will pay 50 percent of the allowed amount for remaining services, up to the $2,000 annual maximum.”

 

Additionally, there is no longer a dental schedule, which means participants can use this benefit for any necessary procedures and they will be reimbursed as described in the previous paragraph. And, the lifetime maximum for orthodontia is being increased to $4,000 per person (orthodontic services count toward the annual $2,000 maximum).

 

Significant improvements are lined up at the Core level, too. As noted in the letter, employees and their dependents covered at this level have been eligible for a maximum of $350 in dental benefits each year. Those benefits were paid according to the SHBP dental schedule, and there also was a lifetime maximum of $1,000 for orthodontia.

 

“Beginning on May 1, the dental benefit is being increased to $1,000 per calendar year for each eligible person at the Core benefit level,” Bowen wrote. “The Plan will pay 100 percent of the first $500 of dental services. After that, if you use an in-network provider, the Plan will pay 60 percent of the network-allowed amount for remaining services, up to the annual maximum of $1,000. If you use an out-of-network provider, the Plan will pay 50 percent of the allowed amount for the remaining services, up to the $1,000 annual maximum.

 

“There is no longer a dental schedule, which means that you can use this benefit for any necessary procedures and you will be reimbursed as indicated above,” she continued. “The lifetime maximum for orthodontia is being increased to $2,000 per person; however, orthodontic services will count toward the annual maximum of $1000.”

 

Additional points covered in the letter include:

 

- The Plan has no dollar limit on preventive dental care for children under age 19. The Plan classifies the following services as preventive: periodic oral examinations, prophylaxis (teeth cleaning), topical fluoride treatment, fluoride supplementation and oral health education. Any claims paid for these preventive dental procedures will be deducted from the applicable annual allowable amounts for that particular dependent.

 

- If a participant has already received dental services this year, the amounts that the Plan has paid will count toward his or her 2016 annual maximum for dental benefits.

 

- As with all health benefits, participants will save money by using in-network providers. To locate an in-network provider, visit www.cignadentalsa.com.

 

Participants should send all dental claims to the Plan directly at the following address: Seafarers Health and Benefits Plan, P.O. Box 380, Piney Point, MD 20674

 

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