Enrollment in dental insurance must be made within the first 31 days of employment. . If hired on or before June 30th 2015, coverage will be effective on the first day of the calendar month following the hire date. If hired on or after July 1, 2015 coverage becomes effective the first of the month following completion of one full calendar month of employment if all applicable forms are completed.
After initial enrollment, changes may only be made:
- within 60 days of a special qualifying event if employee currently has coverage
- during the "Annual Transfer Period" all eligible employees are allowed to add dental coverage
2016 Dental Insurance
Eligible employees can choose from two dental options:
- Prepaid Plan
- Dental Preferred Provider Organization
In 2016, the Prepaid Plan will be administered by Cigna and the DPPO will be administered by MetLife.
The Prepaid Plan provides services at predetermined copay amounts from a limited network of participating dentists and specialists.
- To receive benefits, you must select a dentist from the Prepaid Plan list and notify Cigna of your selection. You can search for participating dentists on Cigna's website.
- There are some areas in the state where the network dentists are not available. Be sure to carefully review the provider directory. Some dental offices may be closed to new enrollment.
- You must use your selected dentist to receive benefits.
- The plan provides services at predetermined member copay amounts (reduced fees) for dental treatments.
- There are no deductibles to meet, no claims to file, no referrals, no waiting period and no annual dollar maximum. Pre-existing conditions are covered.
You can search for participating dentists on Cigna's 2016 Plan Information - select the Cigna Dental Care HMO network.
Dental Preferred Provider Organization (DPPO)
The Dental Preferred Provider Organization (DPPO) provides services with member coinsurance rates. Any dentist may be used to receive benefits, but member cost will be less if an in-network provider is used.
- Use any dentist (receive maximum benefits when visiting an in-network MetLife DPPO provider).
- Member pays coinsurance for covered services. Deductible applies for basic and major dental care only.
- You or your dentist will file claims for covered services. Referrals are not required.
- Some services (e.g. crowns, dentures) require a 6-month waiting period before benefits begin.
- Other services (orthodontics, replacement of missing tooth) require a 12-month waiting period before benefits begin. There are some limitations and exclusions, (e.g. no benefit for cosmetic reasons, congenital malformations, diagnosis or treatment of TMJ.
- You pay coinsurance for many covered services and your share is based on the "maximum allowable charge" (MAC) for a given service.
- You will pay less out-of-pocket when seeking care from a network provider because network dentists and specialists typically agree to the allowable charge up front.
- Out-of-network providers typically charge more than the allowable charge, resulting in higher costs for you.
You can search for participating dentists on MetLife's MYBenefits - select the PDP network.
Continuation of dental coverage through COBRA versus the retiree dental plan
If you are enrolled in dental coverage as an ACTIVE employee under a state sponsored plan and your employment is terminated, you will be given the opportunity to continue your dental coverage for 18 months under the Consolidated Omnibus Budget Reconciliation Act (COBRA). A COBRA notification will be mailed to your home upon the termination of your active coverage. Continuation of dental insurance is NOT automatic at retirement. To continue dental through COBRA, you must complete and return the COBRA enrollment form to Benefits Administration within 60 days of your active coverage terminating. Please indicate if you are a Tennessee Consolidated Retirement System retiree via a hand written note on the signature page of the COBRA enrollment form.
If you do not qualify to continue dental insurance through COBRA or simply wish to enroll in the retiree dental plan upon the termination of your active insurance coverage, you should submit an application directly to Benefits Administration. Please note, you must be a TCRS retiree or an ORP (optional retirement plan) retiree from a higher education agency. You must submit your enrollment application within 30 days of your active insurance terminating or you will have to wait until the next annual enrollment period to enroll.
Human Resources Office
910 Madison Avenue
Suite WP012, 1st Floor
Memphis, TN 38163
Phone: (901) 448-5600
Fax: (901) 448-5170