longshorman

For

Portland/Vancouver Locals 4, 8, 40, 92

• Retirees / Survivors living in the Portland / Vancouver Area

Plans

• Oregon/Washington Dental Service (Delta Dental)

• Oregon Kaiser Dental Plan

• Blue Cross of Oregon Dentacare

DENTAL CHOICE

Eligible families in the Portland/Vancouver 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.


Oregon/Washington Dental Service:

Services provided by any licensed dentist.  By selecting a participating dentist (member of Delta Dental Plan) you are assured direct payment to the dentist and a guarantee of the maximum benefits payable.  The dentist submits the claim to Oregon/Washington Dental Service, and payment is made directly to the dentist.  Most dentists in Oregon and Washington have the necessary claim forms.  For adults, the plan pays 80% of the participating dentist’s usual, customary and reasonable (UCR) fees for covered services.  For children, the plan pays 100% of covered services. (Exception:  Member pays 10% of UCR fees for children’s orthodontia treatment.)

Oregon Kaiser Dental Plan:

All dental services are provided at Oregon Kaiser facilities listed below.  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.  (Exception:  Member pays maximum of $300 for children’s orthodontia treatment.

Services provided at plan facilities only, located in:

Portland     - 5025 S.E. 28th Avenue
- 1314 N.E. Grand Avenue
- 7201 N. Interstate Avenue
- 822 N.E. 181st Avenue
- 10102 N.E. Glisan Street
Beaverton - 4855 S.W. Western Avenue
Clackamas - 10209 S.E. Sunnyside Road
Hillsboro - 19350 N. W. Evergreen Parkway
Tigard  - 7105 S.W. Hampton Street
Vancouver - 12711 S.E. Mill Plain Blvd.
- 14406 N. E. 20th Avenue
Salem - 2300 Lancaster Drive, N.E.
- 5135 Skyline Road South

Blue Cross of Oregon Dentacare

All dental services are provided at plan facilities listed below.  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. (Exception:  Member pays maximum of $250 for children’s orthodontia treatment.

Services provided at plan facilities only, located in:

Albany  - 705 Elm Street, S.W.
Portland  - 13255 S.E. Stark
- 2722 N.E. 33rd
- 4104 S.E. 82nd Avenue
- 1933 S.W. Jefferson
Beaverton - 14495 S.W. Allen Blvd.
Corvallis - 2420 N.W. Professional Drive
Gresham     - 1107 N.E. Burnside Road
Hillsboro     - 1200 N.E. 48th Avenue, Suite 1400
Milwaukie      - 6902 S.E. Lake Road, Suite 200
Salem - 3474 Liberty Road, S.
Tigard - 17130 S.W. Upper Boones Ferry Road
- 9735 S.W. Shady Lane, Suite 203
Vancouver  - 9609 E. Mill Plain Blvd.
- 1201 S.E. Tech Center Dr., Suite 150




Copyright 2005-2006 © ILWU-PMA Benefit Plans. All rights reserved.