Common Open Enrollment Dental Plan Questions

How is Delta Dental PPO different from DeltaCare USA HMO?

The plans have different benefits, provider networks and requirements.

Delta Dental PPO: With Dental PPO, you can see any dentist you wish and receive benefits, and you can go directly to any dentist without a referral. If you use a Delta Dental Network or Premier dentist, you will likely pay less because Delta has contracted with these dentists to provide services at reduced prices. Preventive care is covered at 100% of reasonable and customary fees (as determined by Delta Dental). For other services, you pay an annual $75 deductible and then a percentage of the cost of what the dentist charges for the service. Dental PPO also has an annual benefit maximum of $1,500 per covered person and an additional $1,500 lifetime limit per covered person for orthodontic care.

DeltaCare USA HMO: With DeltaCare USA HMO, you must visit the DeltaCare USA primary care dentist designated on your dental ID card to receive benefits under the plan. There is no deductible, no lifetime or out-of-pocket maximum, and no out-of-network coverage. You pay a set fee for each dental service you receive. The schedule of fees can be found on the A&M System Delta Dental website at https://deltadentalins.com/tamus. The DeltaCare USA HMO plan has a limited network and you must reside in California, Colorado, District of Columbia, Florida, Georgia, Maryland, Minnesota, New York, Tennessee, Texas, or Utah to participate in the plan.

Why are PPO dental plans so popular?

PPO dental plans are probably the most common type of dental plan because they provide flexibility to members to see any dentist they choose, while also offering the advantage of seeing in-network dentists for greater benefits. PPO dental plans are also usually considered full coverage dental plans because they typically have benefits for routine services and exams, as well as major services like crowns and extractions.

How much will I pay for certain services on each of the plans?

Delta Dental PPO DeltaCare USA HMO
Preventive Cleaning $0 $5
Resin filling, front tooth Plan pays 80% $22
Root Canal, back tooth Plan pays 80% $365
Oral surgery Plan pays 80% Depends on services rendered
Crowns Plan pays 50% $395
Upper and lower denture Plan pays 50% $365
Comprehensive orthodontics, such as braces (child) Plan pays 50% $1,900

Full schedule of fees for the DHMO please visit https://www.deltadentalins.com/tamus/pdfs/highlights-dcusa.pdf

How do I contact Delta Dental to see if my services are covered?

You can call Delta Dental toll-free at 1-800-521-2651 and speak to a Customer Service representative Monday through Friday, 6 a.m. to 6 p.m. CST. You may also fill out a customer service form online at https://deltadentalins.com/tamus.

How do I access my hearing and LASIK discounts with Delta Dental?

• For Amplifon hearing aid discounts, go to https://amplifonusa.com/deltadentalins or call Amplifon at 1-888-779-1429.
• For LASIK pricing, go to https://qualsight.com/-delta-dental.

Featured Retirement Vendor: Fidelity Investments

The A&M System has 6 retirement plan providers to choose from to further invest in your future. Each Benefits Briefs issue, we will feature a retirement vendor. This month’s feature is Fidelity Investments.

Fidelity Investments offers financial planning and advice, retirement plans, wealth management services, trading and brokerage services, and a wide range of investment options.

Visit the A&M System Fidelity website for more information. https://nb.fidelity.com/public/nb/texasam/home

Will Planning Services by EstateGuidance and The Hartford

Having a will is important to ensure your wishes are honored in the event of your death, including the division of your property and inheritance. The Hartford, the A&M System’s life insurance plan provider, gives you access to a free online will planning service if you are enrolled in an A&M System life insurance plan. EstateGuidance, the will-planning service that The Hartford provides, makes the will creation process an easy step-by-step questionnaire that in some cases, only requires your signature to finalize!

How to create your will:

  1. Go to https://www.estateguidance.com/
  2. Enter the promotional code in the upper-right corner: WILLHLF
  3. The price for the Last Will and Testament will change to FREE. Click “Get Started”. This code will also discount some other services on the website.
  4. Follow the instructions to begin creating your will.
  5. Download the final will to your computer and print.
  6. Obtain signatures, and determine if your will should be notarized.

Glaucoma and Annual Eye Exams

Annual eye exams are important for identifying eye conditions like glaucoma. The American Academy of Ophthalmology defines glaucoma as a group of eye disorders that damage the optic nerve. The first sign of glaucoma is usually loss of peripheral, or side, vision. Another symptom of glaucoma is halos around lights. Most people with glaucoma have no pain.

Increased eye pressure is thought to cause glaucoma. The increased pressure in your eye, called intraocular pressure, can damage your optic nerve, which sends images to your brain. If the damage worsens, glaucoma can cause permanent vision loss or even total blindness within a few years.

Having regular eye exams can detect these vision problems early, and while there is no way to prevent glaucoma, the major damage and significant vision loss from glaucoma can be prevented.

Glaucoma.org suggests that a check for glaucoma should be done at the following ages:

  • Before age 40, every two to four years
  • From age 40 to age 54, every one to three years
  • From age 55 to 64, every one to two years
  • After age 65, every six to 12 months

The Glaucoma Research Foundation also suggests anyone with high risk factors should be tested every year or two after age 35. Those at higher risk include people of African descent, people with diabetes, and people with a family history of glaucoma. You are at increased risk if you have a parent or brother or sister with glaucoma.

Remember, regular comprehensive eye exams are the best form of prevention against glaucoma and other eye diseases.

COVID-19 Relief Bill – Flexible Spending Account Changes

The most recent COVID-19 Relief Bill, passed on December 27, 2020, made it easier to use your Healthcare Flexible Spending Accounts (FSA) and Dependent Day Care Accounts during the pandemic. The bill included important changes to the The Texas A&M University System FSA benefits. The following changes are now in effect for your FSA or Dependent Day Care Account for the 2020 and 2021 plan years:

Healthcare Flexible Spending Accounts (FSA)

Make changes to your FSA without a qualifying life event (getting married, birth of a child, etc.)

You can make a change in election amounts for plan years ending in 2021 (plan year ending 08/31/2021) without a change in status event. This means you can change your FSA election amount or sign up for an FSA outside of your open enrollment period. You can make this change yourself in Workday by going to the Benefits Worklet, selecting “Benefits” in the Change column, choosing the “Flexible Spending Account Change” Change Reason, and following the instructions.

12 months to incur and claim expenses (extended grace period)

You have 12 months after your plan year ends to incur medical costs and submit claims to your healthcare FSA. This extension is valid for plan years ending in 2020 (plan year ending 08/31/2020) and 2021 (plan year ending 08/31/2021). This means any medical expenses incurred in plan year 2021 (09/1/2020 – 08/31/2021) can be applied to your plan year 2020 FSA (09/1/2019 – 08/31/2020), and expenses incurred in plan year 2022 (09/1/2021 – 08/31/2022) can be applied to your plan year 2021 FSA (09/1/2020 – 08/31/2021). This change gives the employee an additional 12 months to incur expenses and claim your FSA dollars.

Terminated employees FSA accounts

Allowances for Terminated Employees Healthcare FSA participants who terminate their employment during the 2020 plan year (09/1/2019 – 08/31/2020) or 2021 plan year (09/1/2020 – 08/21/2021) can spend down their unused balances for expenses incurred through the end of the plan year in which the termination occurred including the additional 12-month grace period as noted above. You may claim up to the amount deducted from your pay prior to your termination from the plan.

Dependent Day Care Flexible Spending Accounts (FSA)

Make changes to your FSA without a qualifying status events (getting married, birth of a child, etc.)

You can make a change in election amounts for plan years ending in 2021 (plan year ending 08/31/2021) without a change in status event. This means you can change your FSA election amount or sign up for an FSA outside of your open enrollment period. You can make this change yourself in Workday by going to the Benefits Worklet, selecting “Benefits” in the Change column, choosing the “Flexible Spending Account Change” Change Reason, and following the instructions.

12 months to incur and claim expenses (extended grace period)
You have 12 months after your plan year ends to incur dependent day care costs and submit claims to your dependent day care FSA. This extension is valid for plan years ending in 2020 (plan year ending 08/31/2020) and 2021 (plan year ending 08/31/2021). This means any dependent care expenses incurred in plan year 2021 (09/1/2020 – 08/31/2021) can be applied to your plan year 2020 FSA (09/1/2019 – 08/31/2020), and expenses incurred in plan year 2022 (09/1/2021 – 08/31/2022) can be applied to your plan year 2021 FSA (09/1/2020 – 08/31/2021). This change gives the employee an additional 12 months to incur expenses and claim your FSA dollars.

Please reach out to your Human Resources office with any questions.

Taking Care of Your Mental Health During the Holidays

Taking Care of Your Mental Health During the Holidays

During the holiday season, the healthcare industry sees an uptick in mental health inquiries. Researchers believe this is due to a variety of stressors such as:

  • Fatigue
  • Stress
  • Unrealistic Expectations
  • Over-commercialization of holiday times
  • Financial Stress
  • Inability to be with one’s family and friends

With a global pandemic still looming, many families are opting to pass on gatherings this year. This can increase feelings of loneliness and depression. Reducing, eliminating, or finding creative ways to deal with holiday-specific demands on your time, energy, and emotions is important and working with a therapist or accessing other resources on coping with depression may help.

Your A&M System benefits include mental health resources if you are ever in need of them. ComPsych GuidanceResources provides guidance on work/life balance topics such as financial stress, mental health, marriage and family relationships, grief counseling, and more. They prepared a Healthy Holidays toolkit to help you stay cheery through the holiday season.

Go to Guidanceresources.com and register under your institution or agency listing. Use code ‘TAMUS’. They suggest these coping tips to help manage your feelings of depression during and after the holidays:

  1. Talk to a professional. If the blues you are feeling linger for several weeks and are interfering with your ability to enjoy life and function effectively, seek help. A therapist can assist you in exploring your feelings. You can talk to a behavioral health specialist on MDLIVE as well!
  2. Find support in others. Try confiding in trusted family members and friends about how you have been feeling. Be honest with others about what you are experiencing instead of covering up your emotions. An understanding loved one can give you the strength and support you need to help cope with depressive feelings.
  3. Manage your stress. Learn effective ways to reduce your stress and anxiety, which may minimize your feelings of depression.
  4. Exercise regularly. Regular fitness activities can improve your mood and boost your self-esteem. Talk to your doctor about an exercise program that is right for you. Because a lack of sunlight may be contributing to your depression, exercise outdoors for a double benefit.
  5. Eat right. Discipline yourself not to overeat. Avoid junk foods and environments that may encourage binging. Stick to a nutritionally balanced diet. Avoid alcohol, which is a depressant.
  6. Get the proper amount of sleep. Experts recommend at least seven to eight hours a night. Resist the urge to oversleep, and try to maintain a regular sleeping schedule.
  7. Make more time for recreational, fun activities. Try to spend more time outdoors, especially on sunny days.
  8. Be more social. Stay in touch with friends and family.
  9. Consider using a light box. These devices have been used successfully to treat seasonal affective disorder. Talk with your doctor or therapist about whether the increased amount of light could be helpful to you.
  10. Educate yourself. Learn all you can about depression, support groups in your area and ways to manage your feelings.

 

Resources: National Institute of Mental Health (NIMH) – www.nimh.nih.gov;National Institutes of Health (NIH) – http://health.nih.gov; Mental Health America- www.nmha.org; Guidanceresources.com.