ILWU-PMA Benefit Plans - Los Angeles Area Dental Plans

For

• Actives in Los Angeles Locals 13, 26, 63, 94

• Retirees / Survivors living in Los Angeles Area

Plans

• Delta Dental of California

• Harbor Dental Associates (formerly Sakai, Simms)

DENTAL CHOICE

Eligible families in the Los Angeles Area are offered a choice of dental plans. The choice is made when eligibility is first obtained. Plans may be changed during a choice period each year, in May with coverage under the new plan beginning July 1. In addition to the May choice period, members may change their dental plan once at any time during the Plan Year (July 1-June 30). You must give the Benefit Plans Office written notice of your change. The Benefit Plans Office will provide written confirmation of the change and notice of the effective date. Retirees and Survivors are also offered a choice when they move into a new area where more than one plan is available.

If you are a new eligible, or if you want to change dental plans, complete a Dental Program Choice Form and mail to the Benefit Plans office. Choice forms are available at the Locals or the Benefit Plans office.

BENEFITS

The Dental Plans are briefly described in this section. You will be furnished with a Supplemental Summary Plan Description for your Dental Plan at the time you become eligible. You can also obtain a copy at your Local or by contacting the Benefit Plans Office or your Area Welfare Director.

Delta Dental of California

Services provided by any licensed dentist. By selecting a participating dentist (member of Delta Dental) you are assured direct payment to the dentist and a guarantee of the maximum benefits payable. No identification card is necessary. The dentist submits the claim to Delta Dental, and payment is made directly to the dentist. Most dentists in California have the necessary claim forms. The adult dental program pays 80% of the participating dentist’s usual, customary and reasonable (UCR) fees for covered services. The children’s dental program provides covered dental services at no cost to the patient.

Harbor Dental Associates
(formerly Sakai, Simms)

Services provided at group offices only:

25617 Dodge Ave., at Pacific Coast Hwy., Harbor City, CA

8540 S. Sepulveda Blvd. (at Manchester), Suite 815, Los Angeles, CA

All dental services are provided at the Dentists Group offices of Harbor Dental Associates. No identification card is necessary, there are no claim forms to fill out, and no prior authorization of treatment is required. Covered services are provided at no cost to the patient.