Benefits » Health Insurance » Dental
Proper dental care plays an important role in your overall good health. LANL employees participate in the Preferred PPO, which is administered by Delta Dental of California. This plan helps you save on out-of-pocket expenses for basic, prosthetic, and orthodontic services due to the reduced total fees charged by participating dentists. (Fees will vary according to your region and the dental procedure.) You will find a list of participating providers by going to the Delta Dental of California website. Dentists in either the Preferred PPO Network or the Premier PPO Network are considered to be in-network, but the Preferred PPO providers provide the most favorable benefit.
You are eligible for dental coverage if you qualify for Full Benefits. When you qualify, your eligible family members who meet eligibility requirements include your legal spouse or domestic partner, child, grandchild, adult disabled child, and legal ward.
You may enroll yourself or an eligible family member in dental coverage during Open Enrollment, which is held at the Lab each November, with coverage effective January 1st of the following year.
There are no exclusions for pre-existing conditions.
No ID Cards are provided with this plan. When you visit a Delta Dental provider, you merely need to let them know you are enrolled in Delta Dental CA Preferred PPO and they will be able to verify your eligibility. Your member number is your Social Security number. All eligible family member information will be under this same number.
If you are newly hired, you have a period of initial eligibility (PIE) during which you may enroll yourself and your eligible family members. Your PIE starts the day you become eligible (i.e., your date of hire) and ends approximately 31 days later.
To enroll, submit a completed insurance enrollment form (pdf) to the Lab's Benefits Office within 31 days of your PIE.
If you are a new employee, there is a chance that Delta Dental may not yet have you in their system. If your dentist informs you that you are not eligible, contact the Lab's Benefits Office at 505-667-1806 or email to verify eligibility.
If you missed your PIE, you can still enroll in dental coverage during Open Enrollment, which is usually held in November for coverage effective January 1st of the following year.
You may become eligible for LANS-sponsored benefits if you change employment status (e.g., change from contractor to LANS or limited benefits to full benefits). If this happens, notify the Lab's Benefits Office immediately by calling 505-667-1806 or sending email to determine when your PIE begins and to register for a benefits presentation. You will have a 31-day PIE from the date your employment status was changed.
Families change and grow due to marriage, birth or adoption of children, and other events. If you are enrolled in a dental plan, your newly eligible family member(s) may be added to your current plan. You must request enrollment within 31 days from the date your family member is first eligible (e.g., date of marriage or date of child's birth).
To enroll, contact the Lab's Benefits Office at 505-667-1806 or send email.
If you are not enrolled in a dental plan, you and your eligible family members may enroll during Open Enrollment, which is usually held in November for coverage effective January 1st of the following year.
If you and/or an eligible family member involuntarily lose other employer-sponsored dental insurance coverage, you may enroll in one of LANS's dental plans. A new PIE starts the day you lose coverage. You must furnish proof that your other employer-sponsored coverage was lost.
To enroll, contact the Lab's Benefits Office at 505-667-1806 or send email.
Currently, LANS pays the entire monthly contribution for all employees. All plan members pay a certain percentage or copayment for some services.
If you choose a Delta provider, the plan pays for services. Most preventive dentistry is covered in full. For other services, you pay a $50 annual deductible per person and a coinsurance (i.e., cost-sharing with the insurance company) of 25%–50% of the charges. Delta dentists file claims for you.
If you prefer to use a dentist who is not a Delta provider, you will need to pay in full for those services and then submit a Delta Claim Form (pdf) to receive reimbursement at the approved levels for the services.
To locate a participating Preferred or Premier Network dentist, use Delta's website.
For assistance with claims payments, contracting services, and other general customer issues, contact Delta Dental of California at 1-800-777-5854.
This is only an overview of the dental insurance plan. For more information on what the plan covers, see the Dental Plan Summary (pdf) or check out the Delta Dental Web site.
Questions? Contact the Lab's Benefits Office at 505-667-1806.