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Aetna Dental Plan
Effective July 1st, 2005, the LIUFF has transferred
our Dental coverage to from Horizon Dental Insurance to Aetna. There
were several reasons for this switch:
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Aetna provided the opportunity for domestic partner and full family
coverage.
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Aetna's network consists of 11,232 providers at 5,665 locations whereas
Horizon's network consists of 8,955 providers and 7,390 locations.
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The individual rate from Aetna is comparable to that of Horizon and
will not necessitate an increase in full dues.
On May 17th, 2006, the Executive Committe
unanimously decided to renew our dental insurance with Aetna. As
expected, rates will increase. The exact percentage was by 7.33%.
The increase would have been greater, but the Executive Committee decided
on an option which woudl change out-of-network coinsurance payments in
order to manage the increase. Changes are as follows:
Payment Schedule for Out Of Network
Procedures
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Procedure
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Current Rate
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New Rate
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TypeA-Preventative |
100%
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90%
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Type B-Basic |
80%
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70%
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Type C-Major |
50%
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50%
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Rates Effective July 1, 2006
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Coverrage
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Current Monthly
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New Monthly
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Single |
$36.13
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$38.78
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Single + 1 |
$68.52
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$73.54
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Family |
$100.90
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$108.29
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Also, under the new plan, the $5 copayment for the DMO has been removed.
In addition, Aetna offers a DMO plan with significantly reduced copayments
and charges for procedures. Uniquely, Aetna allows participants to
switch between the PPO and the DMO on a monthly basis.
EVERYONES RATES WILL BE LOWER WITH A LARGE PARTICIPATION
IN THE DMO!
FACULTY ARE STRONGLY URGED, WHERE PRATICAL, TO MIGRATE
TO THE DMO!
If you wish to enroll in the dental plan for the first time, or switch
to the DMO, please print out the enrollment form, available through the
link on the upper tool-bar, and return it to :
Edward Donahue
Chemistry Department
Family Coverage.
As in the past year, anyone on "Single +1" or "Family" coverage will
be billed biannually for the difference between the single coverage rate
(which is included in dues) and the enhanced coverage. Since we will
have enhanced coverage for a full year, these payments will be due every
six months. Notifications will be sent through the mail.
PAYMENTS DUE FOR SINGLE + 1 and
FAMILY COVERAGES
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Plan
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6 Month Bill
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Payment Due Date
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LIUFF member + 1 |
$208.57
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7/15/06
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Family (3 or more) |
$417.06
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1/15/07
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Carryover of Deductible:
Aetna will honor Horizon's deductible for 2005. However, you
may have to provide proof. If you filed any claims with Horizon,
you received an Explanation of Benefits (EOB) which stated that you have
met your deductible. A copy of this may be requested by Aetna. If
you do not have a copy, Horizon will provide you with one upon your request.
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