ILWU-PMA Benefit Plans - Washing Area Dental Plans

For

• Washington Locals 7, 19, 21, 23, 24, 25, 27, 32, 47, 51, 52, 98

• Retirees / Survivors living in Washington

Plans

• Washington Dental Service (Delta Dental)

• Dental Health Services

DENTAL CHOICE

Eligible families in the Washington 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.

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.)

Dental Health Services:

Under this plan, all services are provided by DHS contracted dentists. You must choose a dentist from the list of Dental Health Services Participating Providers as your regular dentist. You must see this dentist except for emergencies. No identification card is necessary, there are no claim forms to fill out, and no prior authorization of treatment is required. Most covered services are provided at no cost to the patient.