Welcome to the Info TEST server!

Skip to content. | Skip to navigation

Sections
Human Resources > Benefits > Dental Benefits

Dental Benefits

Plan Info

Enrollment

Use Delta Dental

HSA

Dental Plan Highlights

Two coverage options are available:

  • "High Plan" (Comprehensive)
  • "Low Plan" (Basic)
  • Enrollment is allowed only as a new hire, through qualifying events, or biannual (2yr) open enrollment
  • Coverage is continuous unless actively changed

Basic Plan

  • Preventative services covered at 100% (not subject to deductible)
  • Basic dental services covered at 80%
  • Annual maximum benefit of $1000

Comprehensive Plan

  • Preventative services covered at 100% (not subject to deductible)
  • Basic dental services covered at 80%
  • Other basic dental services covered at 50%
  • Major dental services covered at 50%
  • Orthodontic services covered at 50%
  • Annual maximum benefit of $1500

 

      2-Step Enrollment

      Two steps to enroll in the Delta Dental Plan of your choice:

       

      1. Complete the Medical/Dental/Vision enrollment form

      2. Complete the Salary Reduction Agreement form
      - if you intend to contribute your own money to your HSA

      Provider Look-Up

      Delta Dental LogoFind a Dentist
      Or by telephone:

      800-237-6060

       

      Delta Dental Online

      Delta Dental logoDeltaDentalVa.com
      Website registration is required

      • Track claims
      • Next cleaning eligability
      • View Explanations of Benefits
      • In-network provider look-up
      • Manage plan ID cards
      • Your Cost Estimator

       

      Health Savings Account Highlights

      • The Health Savings Account is held by PNC Bank.
      • Allows employees to set aside money on a tax-exempt basis to pay for qualifying medical, dental and vision expenses
      • For 2019, the employer will be contributing $500 for single accounts and $1000 for family accounts.
      • You can change employee contributions at any time throughout the year.

       

      Plan Documents and Links

      Link to NRAO WebpageCurrent Year Dental Premiums

       

        Dental Plan Document
        Document regulating AUI's benefit plan (excluding medical) administration. Plan definitions, eligibility, funding, COBRA and HIPAA requirements, claims and appeals are covered.

         

        Summary Plan Description

        "High Plan" (Comprehensive)

        "Low Plan" (Basic)

        Erollment Forms and Links

        Medical/Dental/Vision enrollment form


        Salary Reduction Agreement - HSA

        Claim Forms

        Dental Claim and Predetermination Form

        HSA Documents and Links

        HSA FAQ

         

        Using Your HSA Card

         

        Link to NRAO WebpageCurrent Year Employer Contributions and IRS Limits

         

        IRS LogoIRS HSA Publications

         

        IRS LogoIRS Defined Qualifying Expenses

        "Summary of Coverage and Benefits" document

        The Patient Protection and Affordable Care Act (PPACA) requires the AUI Comprehensive Medical Insurance Plan to provide a “Summary of Coverage and Benefits” to plan participants prior to the close of annual open enrollment.

         

        These documents follow specific federal guidelines. Please note that these are only summaries and do not outline the comprehensive details of your plan. For complete coverage details you should refer to the Summary Plan Description for your plan as posted on this site.

        The updated current year Summary Plan Descriptions will be available online and in hard copy form upon request in the first quarter of the current year.

        You have a right to receive a paper copy of the Summary of Coverage and Benefits upon request at no charge to you. If you would like to request a paper copy, or if you have any questions, please contact the benefits office.