Support Staff:  Coverage will become effective the first day of the month following date of hire, provided enrollment occurs within 60 days of employment.

Summary of Benefits:

• Dental coverage is available through one of the following dental plans:
  • Delta Dental Plan, a traditional dental plan, or
  • Aetna, a dental maintenance organization (DMO).
• Delta Dental Plan pays 50% of usual, customary and reasonable charges for most dental services, as defined in the Master Policy (available from MSU Human Resources Benefits).
  • There is no deductible that the employee is responsible for. 
  • Benefit payments are limited each calendar year to $600 for each covered person.
  • Orthodontic services are covered for persons under age 19 and are limited to a separate lifetime maximum of $600.
  • If employee and spouse or MSU-recognized same-sex domestic partner are both enrolled University employees, the plan provides up to 100% of usual, customary and reasonable charges for most dental services, as defined in the Master Policy (available from MSU Human Resources Benefits).
• Aetna DMO utilizes primary care dentists to lower the cost -- it is a managed-care dental plan. Members select a primary care dentist (PCD) from the provider network and visit their PCD as needed for treatment and care.  Highlights of the plan include:
  • Fixed co-pays for services
  • No annual or lifetime benefit maximums
  • No annual or lifetime deductibles
  • Orthodontia is available for adults and children

Premium contribution:

The University contributes 100% of the monthly premium for full-time (90 - 100%) employees and employees on flexible appointments; 75% of the monthly premium for eligible 3/4-time employees (65 - 89.9%); and 50% of the monthly premium for eligible half-time employees (50 - 64.9%). The employee's partial premium (if any) will automatically be payroll deducted for eligible part-time employees. Official retirees and employees not receiving a payroll check will be billed. Retirees and LTD recipients may continue participation based on their employee group and status during their active employment (VARIES: Employees on a family medical leave [FMLA] will continue to receive the University premium contribution - see Policy and Procedure for Family Medical Leave Act [FMLA]).

Termination date of benefit:

1. Dental coverage will terminate when one of the following occurs:
   • last day of employment, or
   • date of transfer to an ineligible status unless the employee is an official Michigan State University retiree or elects COBRA continuation of coverage.
2. This benefit continues for faculty on layoff or approved leave of absence for up to 24 months. Part-time employees will be billed for their portion of the premium.
3. Dependent coverage terminates as above. In addition, certain changes in dependent status terminate coverage for dependents as defined in the Master Policy (available from MSU Human Resources Benefits).

COBRA continuation of coverage:

In accordance with the Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA), group dental coverage for eligible employees and their dependents may be continued in the following situations:

1. Upon termination of employment  or transfer to an ineligible status, employees and/or covered dependents may elect to continue group dental coverage for a period of up to 18 months (29 months if disabled and receiving Social Security Disability) on a cash basis.
2. In the event of the employee's death, divorce, legal separation, termination of a MSU recognized same-sex domestic partner relationship, or a dependent's loss of coverage due to age or loss of IRS dependency, dependents may elect to continue group dental coverage for a period of up to 36 months on a cash basis.

COBRA coverage must be elected in writing to MSU Human Resources Benefits by the eligible employee or dependent within 60 days of the qualifying event.

Conversion of coverage:   No conversion possible. 

Procedure

Application for enrollment:
 
Employee:

1. Enroll within 60 days of initial employment or appointment to an eligible status by accessing the web site at www.hr.msu.edu; click the eHR Services Login link, enter your MSUnet ID/Pilot ID and password.
2. If enrollment does not occur within 60 days of initial enrollment or appointment to an eligible status it is necessary to wait for an annual open enrollment period.
3. During annual open enrollment eligible employees and retirees may:

• enroll,
• change carriers or
• add eligible dependents.

4. Dependent unmarried children incapable of self-support due to mental or physical disability may remain covered under the contract under Michigan Public Acts 274 and 275, however the disability must be identified by a physician prior to age 19.

Changes in coverage or personal information:

Employee:

1. To make the following changes, access the MSU Human Resources Benefits website at www.hr.msu.edu; click the eHR Services Login link, enter your MSU NetID and password:
   • the addition of dependent(s) within 31 days of acquiring the dependent through birth, marriage or same-sex domestic partnership, adoption, etc. (action not taken within 31 days will require waiting for an open enrollment period),
   • a deletion of dependent(s) when no longer eligible for coverage due to death, divorce, marriage, change of dependent status, graduation from college, termination of same-sex domestic partnership, etc.,
   • dependents who turn age 19 and are attending school full-time or
   • cancellation of coverage.
2. Contact MSU Human Resources Benefits whenever the status of a dependent changes.
3. Contact MSU Human Resources Benefits to elect continuation of dental coverage, under COBRA provisions, within 60 days of any qualifying event (see this Policy under "Policy: COBRA continuation of coverage" for applicable qualifying events).

Processing claims:

Employee:

1. Delta Dental:  Obtain dental claim forms from the dentist's office (if in Michigan), MSU Human Resources Benefits, or Delta Dental. If services proposed by the dentist exceed $200, the completed claim form should be submitted to Delta Dental by the dentist for predetermination prior to providing services. Delta Dental will return form to dentist indicating amount covered under plan.
2. Aetna DMO: No claim form is needed by employee/retiree.

Premium payment (part-time employees on unpaid leave of absence, COBRA participants, and some retirees):

MSU Human Resources Benefits: Sends premium notice to individual's home address for payment of premiums due.

Refer questions to:  MSU Human Resources Benefits (telephone 517-353-4434 or e-mail benefitsinfo@hr.msu.edu)