IPPFA Benefits has arranged for a Dental & Vision insurance plan for IPPFA members, retirees, and their eligible dependents.

This benefit provides coverage for you and your eligible dependents for Preventative, Basic Type II, and Major Type III dental services, such as exams, cleanings, x-rays, fillings, crowns, root canals, etc. (Orthodontia is not included). In addition, this plan includes a vision benefit program that covers eye exams, frames, lenses, and contacts.

This program has been arranged through IPPFA as part of its continuing effort to provide benefits to our fellow public sector workers. This plan is administered by IPPFA Benefits and insured with Ameritas.

You are automatically eligible for this Dental & Vision Group Plan.

Your Dependents are also eligible:

• Your legal spouse
• Qualified Domestic Partners
• Your Qualified Domestic Partner's children
• Your dependent children (children are eligible until age 26)
• Legally adopted children
• Step-children who depend on you for most of their support and maintenance

THE DENTAL PPO BENEFIT

This high-quality plan offered by IPPFA Benefits and insured by Ameritas Group gives members access to over 150,000 PPO Dental Providers nationwide. Your favorite Dental Provider is still covered even if they are not in this expansive network. This flexibility allows you to use the Dental Provider that best fits your specific needs.

The PPO Dental plan allows you to visit any dentist or specialist you choose any time care is needed. If you elect to visit an Ameritas network provider, you will receive the highest level of benefits and save on out-of-pocket costs. Best of all, your Preferred PPO features one of the industry's most extensive nationwide dental networks with over 150,000 provider locations.

• Cost Effective: Ameritas network dentist fee discounts average up to 40% less than what dentists usually charge.

• High Satisfaction: 97% satisfaction rate among members who have seen a dentist.

The above is intended only as a brief summary of benefits. It is not an official statement of those benefits.

*The plan pays a specific amount for each dental service based upon an established fee schedule. If you go to an Ameritas PPO provider, the benefits described apply. If you go to a non-Ameritas provider, the amounts charged over the scheduled fees are the patient's responsibility.

THE VISION BENEFIT

Both the Silver and Gold plans include the Vision Benefit. Vision benefits provided cover 100% of fees up to $150 per year. In addition you are eligible for discounted rates on Frames and Lenses at any Walmart Vision Center nationwide.

Our vision plan allows you to visit any eye doctor you wish.

The IPPFA Dental & Vision Plan is offered in a Silver or Gold Coverage Option

SILVER Plan*	GOLD Plan*
The Silver Plan covers 100% of fees for Preventative Dental Services, and 50% of fees for Basic Dental Services.	Coverage is increased from 50% to 80% of fees for Basic Dental Services. In addition, the Gold Plan also covers 50% of fees for Major Dental Services including Crowns & Crown Repair, Prosthodontics, Dentures, Bridges, Inlays, and Onlays.
Both Plans include 100% Vision Services (up to $150 per year) for eye exams, single vision, bifocal, trifocal, lenticular, & progressive lenses, elective & medically necessary contacts, and frames.
* See Coverage Tab and Plan Forms for a detailed list of covered items, plan details, and plan limits

Premium Payments & Grace Periods: The IPPFA Dental and Vision Plan is offered as a combined package. Premium must be paid via automatic ACH bank drafts or by credit card (Visa or Mastercard). Drafts occur on the 15th of the month for the following month (example, October 15th for November's coverage). If the 15th falls on a weekend or holiday, the draft occurs on the next business day.

Termination Requests: Termination requests must be received in writing by mail, fax or e-mail within the same month of the requested termination date. Terminations can only be processed on the last day of the month. Mid-month terminations are not allowable.

The Ameritas Dental PPO Network

Our Size

Our Network includes over 150,000 PPO provider access points located nationally.

Our Savings

Using PPO provides the best claims experience because claims are adjudicated at our contracted amount. Employers who choose to include PPO save an average of 10% to 40% off the median dental claims cost.

Our Hands-on Approach to Quality

Ameritas Group's PPO network-building goals are to contract with the dentists used by our customers, and to maintain an optimal accessibility of providers to achieve quality as well as cost savings. Our comprehensive credentialing process includes:

primary source verification of dental license and DEA (Drug Enforcement Agency) certificate to confirm that dentists are licensed and to uncover whether there is disciplinary action

query of National Practitioner's Data Bank and Healthcare Integrity and Protection Data Bank if applicable

verification of malpractice insurance

review of any license disciplinary action or malpractice suit information discovered

We re-credential our dentists periodically to make sure they continue to fall within the accepted parameters.

 

Welcome Letter

Silver Plan Summary

Gold Plan Summary

Fill-in Dental Claim Form

Fill-in Vision Claim Form