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Dental Plan

The information below is for the plan year ending 12/31/2015. Information for the 2016 plan year can be found on our Annual Enrollment page. This page will be updated with 2016 plan information once that plan is current.

Two dental plans are offered through UnitedHealthcare.  Employees have the option of choosing a
Basic Dental Plan or an Enhanced Dental Plan.  Participants may visit any licensed dentist with either plan.  However, if the Enhanced Plan is selected, it is to the advantage of the plan participant to visit an in-network dentist.

Eligibility for Enrollment

Employees appointed for more than 120 days and 75% of full-time or greater are eligible for enrollment.

Effective date of Coverage

  • New Employees have 30 days to either enroll or waive coverage.  Coverage is effective on the first day of the month after completion of one full calendar month of employment.
  • Employees who do not enroll within the first 30 days may elect to enroll during the Annual Enrollment period held in October of each year with an effective date of January 1.
UnitedHealthcare's Customer Service: 1.877.816.3596
Policy number: 903022
Informational Video about the Dental Plan Benefit - Dentist Locator, Plan Information, ID Cards, Claims Information

Brief Summary of plans and rates
Dental Enrollment/Change Form, Family Status Change Form

Premium Rates - 12 month (9 month)
Coverage Plan     Enhanced Plan Basic Plan
Employee Only $32.87 ($43.83) $17.88 ($23.84)
Employee + Spouse $64.33 ($85.77)     $33.60 ($44.80)
Employee + Child(ren) $78.19 ($104.25) $46.45 ($61.93)
Family $109.68 ($146.24) $62.16 ($82.88)

Enhanced Dental Plan

This plan is designed to help you meet the expense of dental care by providing comprehensive coverage.  Visit for a list of in-network dentists (use the *National Options PPO 30 Network for the Enhanced plan. The difference in networks is only for services received out of Louisiana) or to register if you're enrolled. 

Enhanced Plan Additional Benefits
    *MaxMultiplier - Allows members to carry forward a portion of their unused annual dental maximum into an account for future use. At least one preventative dental claim must be filed during the coverage period to qualify. There is a bonus when you use a network dentist for all services. More information can be found here
    *Preventative MaxMultiplier - Pays for preventive and diagnostic care without deducting from plans annual maximum.

Benefits Booklet - (Enhanced Plan Document and Fee Schedule)

Basic Dental Plan

This plan covered preventive services and features a benefit schedule for all other services.  Visit for a list of in-network dentists (use the *National Options PPO 20 Network for Basic plan. The difference in networks is only for services received out of Louisiana) or to register if you're enrolled.

Benefits Booklet  - (Basic Plan Document and Fee Schedule)

Related Files
FilenameDescriptionFile Size
Dental+Services.pdf 72.92 KB
Dental-Plan---Basic---Benefit-Highlights.pdf 41.89 KB
Dental-Plan---Basic---Employee-Benefit-Booklet.pdf 521.28 KB
Dental-Plan---Enhanced---Employee-Benefit-Booklet.pdf 562.42 KB
Dental-Plan---Enhanced---Benefit--Highlights.pdf 184.03 KB
UHC---Dental-FAQ.pdf 282.08 KB
UHC-Dental-Prenatal-Benefit-Employee.pdf 247.83 KB
UHC-Dental-Provider-Nomination.pdf 12.69 KB
SNIP---Dental.pdf 281.63 KB
UHC---Dental-Claim-Form.pdf 1,028.62 KB
UHC---MaxMultiplier-Rollover-Benefit.pdf 254.17 KB
Last Updated: 10/2/2015 7:54:59 AM

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