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For questions and issues with dental coverage and enrollment, you may write directly to askhr@umass.edu for current enrollment forms. For billing or policy inquiries contact Health Plans Inc., 1-877-906-5939
BHE Dental Plan enrollment form (1)The dental form should go through HR to be processed:
For reference, see below for an overview of the coverage; and for the revised MetLife-H & W dental policy certificate:
MetLife H&W Dental Insurance _ rev 2018 MetLife H & W Policy _ Dental InsuranceAn overview of our plan:
| Coverage Type | PDP In-Network | Out-of-Network |
|---|---|---|
| Type A (For example, cleanings, oral examinations and other maintenance type procedures) | 100% of PDP Fee | 80% of R & C fee |
| Type B (For example, fillings and other standard dental procedures) | 80% of PDP fee | 60% of R & C fee |
| Type C (For example, bridges and dentures and other complex procedures) Note: If you're redoing a crown, bridge or implant, you must wait 10 years in order to have it covered. | 50% of PDF fee | 30% of R & C fee |
| Deductible | In-Network | Out-of-Network |
| Individual | $50.00 | $50.00 |
| Family | $150.00 | $150.00 |
| Annual Maxiumum Benefit | In-Network | Out-of-Network |
| Per Person | $1200.00 | $1200.00 |
*PDP Fee refers to the fees that participating PDP dentists have agreed to accept as payment in full, subject to any co-payments, deductibles, cost sharing and maximums.
**R&C fee refers to the REasonable and Customary (R&C) charge, which is based on the lowest of (1) the dentist’s actual charge, (2) the dentist’s usual charge for the same or similar services, or (3) the charge of most dentists in the same geographic area for the same or similar services as determined by Metlife.
Other notes:
–Dependents are covered until the age of 26. You no longer have to prove they are a students.
–A recent change is that major work, like crowns, bridges and implants can only be replaced after 10 years. This was a cost-saving addition for the trust, but will affect those of you who need a replacement for any of the mentioned services that were done within the 10 year period.
MetLife Vision Access Program
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