DENTAL PLAN:

             Eligibility
           Deductible and Co-Insurance Percentage
           Summary Plan Description
           Bargaining Unit Dental Plan Amendment 01.01.08
           Dental Claim Forms 
          
Premium      

Eligibility
Full-time Faculty working at least 32 hours a week are eligible for the dental plan. An Employee will be covered under the Plan the first day of the month following 30 days of employment.

Dependent coverage will take effect on the day that the Eligibility Requirement is met. A dependent is considerd an employees' spouse or child. (See the Summary Plan Description for the definition of a dependent.)

Deductible and Co-insurance Percentage
The dental insurance includes a $50 deductible for single coverage and $150 for family coverage per calendar year.

Co-insurance varies according to the type of treatment. Preventative services are paid at 100% of R & C (Reasonable and Customary) charges (this includes oral exams and cleaning two times per calendar year).  Basic Services are covered at 80%, after the deductible. Major Services are covered at 50%, after the deductible. Orthodontic Services are available to Dependent Child to age 19. Orthodontic Services are covered at 50% after the deductible with a lifetime maximum benefit of $1,000.

Premium
The cost of coverage is included in the health care premium.

Please Note: There is no Preferred Provider Program for dentists. Therefore participants may select a dentist of their choice.

UMR is Palmer’s third party administrator for the Dental Plan.

Please contact UMR for information and questions regarding your claims at 1-866-868-7241.

Send claims to:
UMR
P.O. Box 30541
Salt Lake City, UT 84130-0541