Health Insurance Plan Options

Dental PPO Plan Coverage

Emeriti is very pleased to announce that you can now enroll in a group dental plan, underwritten by Aetna:

• If you elect this coverage, you will pay the premiums through your Health Account, just as with your Emeriti health insurance.
• If your (over-65) spouse is also covered under Emeriti, you will both have to elect dental coverage, since Emeriti requires that both of you elect the same options.
• If your spouse and/or eligible dependent children are covered under an Emeriti pre-65 plan, dental coverage will be available for them too.

Under the Aetna Dental^® Preferred Provider Organization (PPO), you may choose at the time of service either a PPO participating dentist or any non-participating dentist. With the PPO plan, savings are possible because the PPO participating dentists have agreed to provide care at negotiated rates. Non-participating dentists will only be paid based on the standard negotiated rate provided to participating general dentists in the same geographic area.

Click on these links for more information describing the dental coverage and premium rates.

How to Enroll
If you want to enroll in the dental insurance, you will need to call the telephone center. Please call the same number, 1-866-EMERITI (1-866-363-7484), for any questions that you may have. Please note that you cannot have dental insurance by itself; you must also be enrolled in one of the other Emeriti plan options.

Emergency Dental Care
When emergency services are provided by a participating PPO dentist, your copayment/coinsurance amount will be based on a negotiated fee schedule. When emergency services are provided by a non-participating dentist, you will be responsible for the difference between the plan payment and the dentist’s usual charge. Covered emergency services may vary, based on state law.

The information above is subject to change without notice. In case of a conflict between your plan documents and this information, the plan documents will govern.

In the event of a problem with coverage, members should contact Member Services at the toll-free number on their ID cards for information on how to utilize the grievance procedure when appropriate. All member care and related decisions are the sole responsibility of participating providers. Aetna Dental does not provide health care services and, therefore, cannot guarantee any results or outcomes.

Dental plans are provided or administered by Aetna Life Insurance Company, Aetna Dental Inc., Aetna Dental of California Inc. and/or Aetna Health Inc.

In Texas, the Dental Preferred Provider Organization (PPO) is known as the Participating Dental Network (PDN), and Indemnity Dental plans are provided or administered by Aetna Life Insurance Company.

This content is for informational purposes only and is neither an offer of coverage nor dental advice. It contains only a partial, general description of plan or program benefits and does not constitute a contract. The availability of a plan or program may vary by geographic service area. Certain dental plans are available only for groups of a certain size in accordance with underwriting guidelines. Some benefits are subject to limitations or exclusions. Consult the plan documents (Schedule of Benefits, Certificate/Evidence of Coverage, Booklet, Booklet/Certificate, Group Agreement, Group Policy) to determine governing contractual provisions, including procedures, exclusions and limitations relating to your plan.