Direct Reimbursement (DR) DENTAL PLAN
This custom designed plan is administered by DR Administrative Services. Features of this plan include:
- Freedom to choose your own Dentist or Dental Specialist
- The DR Dental Plan pays the first $200 of dental expenses; up from $150 in 2014.
- Additional expenses are shared 50:50 by the member and the plan, up to the annual maximum benefit of $1,500 per enrolled member per year.
- Benefits are payable to the dentist or member depending upon provider payment options.
- You know exactly what the DR Plan covers:
- ALL dental expenses and procedures are covered except for bleaching and laminates.
- Orthodontic for children and adults - each with a separate lifetime maximum benefit of $1,000.
- Minimal Rules - your dental care is treated as a trust; strictly between you and your provider.
Go to the DR Administrative Services website to obtain claim forms, review and print processed claims, and more.
MetLife DENTAL PLAN -
EFFECTIVE JANUARY 1, 2015
The MetLife Dental Plan, PDP Plus, is new for 2015 and is a managed care plan designed to provide the opportunity to get more benefit for your dental care dollars.
- Select your Dentist or Dental Specialist from the MetLife network.
- Deductibles* are $50 per Individual and $150 per Family.
- Annual maximum benefit is $2,000 per person.
- Orthodontia lifetime maximum is $1,500 per person.
- Additional costs:
|Type A - cleanings, oral examinations||100% of Negotiated Fee†||100% of R&C Fee‡|
|Type B - fillings||80% of Negotiated Fee†||80% of R&C Fee‡|
|Type C - bridges and dentures||50% of Negotiated Fee†||50% of R&C Fee‡|
|Type D - orthodontia||50% of Negotiated Fee†||50% of R&C Fee‡|
* Applies only to Type B and C services.More Information:
† Negotiated Fee refers to the fees that participating dentists have agreed to accept as payment in full, subject to any co-payments, deductibles, cost sharing and benefits maximums. Negotiated fees Negotiated Fee are subject to change.
‡ R&C Fee refers to the Reasonable and Customary (R&C) charge, which is based on the lowest (1) the dentist’s actual charge, (2) the dentist's usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by MetLife.
|MetLife Dental Plan Summary|
|Baylor's Dental Policy|
|Quick Comparison MetLife and Direct Reimbursement (DR) Dental Plans|
|MetLife Transition of Care Guidelines|
Choose a Dental Plan and Enroll (or decline if you do not need a plan). Complete the 2015 Benefits Enrollment Application/Change Form to enroll/make changes to your plan, which also provides authorization for payroll-deduction of pre-tax premiums.
New hires must enroll/decline within 30 days of hire. Enrollment changes must be made during Open Enrollment or within 30 days of a qualifying life event.
Note: Baylor faculty/staff with Baylor spouses will want to review: *current dental coverage *current dental premiums vs. new dental premiums *Whose dental plan are you on? *Who is covering the family? *Which plan is the best choice for the needs of your family?
Note: The below plans will no longer be available effective January 1, 2015.
QCD of America Discount Plan - Red or White OptionThe QCD Red plan is a managed cost dental and vision benefit program. The member pays an affiliated QCD dental provider at time of service according to the QCD Schedule of Program fees. All eligible dependents of the employee may be included under this plan at Baylor's expense.
The QCD White program is an enhanced managed cost dental and vision program. Members pay an affiliated QCD dental provider at the point of service according to the QCD Schedule of Program fees. The member submits a copy of the statement of services by fax to QCD for reimbursement. QCD reimburses the member for services listed by code on the White Reimbursable Fee Schedule.
DR Dental Customer Service
Phone: 1-888-791-3737 Fax: 1-888-791-1313