Retiree Dental Plan - Harrison Electrical Workers Trust Fund

Trust Dental Plan

The Retiree Plan makes the Trust Dental Plan available to you as an option for dental coverage.

New Retirees

If you are a new retiree (who has not been eligible for coverage through the Harrison Trust in any of the previous 12 consecutive months) you, your spouse and your dependents will be eligible for dental benefits after six months of coverage under the Harrison Trust.

Eligibility for Dental Care Benefits

If you are covered under the Early Retiree Plan, you, your spouse and dependents will have dental coverage described in this section, or if you reside in the Kaiser service area you may choose the Kaiser Dental Plan.

If you are covered under Retired Plan A, B or C, you have the option of purchasing dental coverage for yourself, your spouse and dependents. You may choose to purchase dental coverage during open enrollment, which is in November for coverage effective January 1. Your choice will last the entire year, and you may add or drop dental coverage only during the open enrollment period for coverage the following calendar year.

Comprehensive Dental Benefits

Dental Maximum Per Person Per Calendar Year	$1500. You can make a written request to the Plan Administrator that up to $500 of the following calendar year's dental maximum be used to pay covered dental charges in the current year. You cannot use this procedure for two consecutive calendar years. You cannot use or borrow from another family member's dental maximum.
Dental Benefits at 80%	Covered charges for orthodontic benefits up to the lifetime maximum of $2,000. Covered dental charges for routine exams and for routine prophylaxis (cleaning and scaling of teeth by a dentist or dental hygienist) but no more than twice during a calendar year.
Dental Benefits at 70%	Covered dental charges other than those payable at 80% and 50%
Dental Benefits at 50%	Covered dental charges for dentures, gold fillings, crowns, inlays, onlays and bridgework.
Orthodontic Lifetime Per Person	$2,000.00
Deductible	$25 per person per calendar year. The maximum deductible a family must pay per calendar year is $75. All dental charges including orthodontic benefits, routine exams and routine prophylaxis are subject to the deductible.

If contemplating dental work in excess of $300, you are strongly urged to submit to the Plan Administrator, in advance, a copy of the treatment plan, commonly called predetermination of benefits. The dentist performs the examination, including x-rays, then list on the predetermination form the procedures and charges necessary to complete the treatment. The completed form, together with the x-rays, are then sent to the Plan Administrator where the amount payable under the Plan will be computed and you will be informed of the amount that will be paid by the Plan.

If you do not request predetermination of benefits, the Plan Administrator will calculate benefits on the basis of the amount of benefits that would have been paid had you requested predetermination.

Predetermination is encouraged, particularly if the course of treatment is expected to involve total dental charges in excess of $300.

The dental expenses must be incurred for dental procedures necessary to your care and treatment and performed by or under the direct supervision of a legally qualified dentist.

The charge for a dental procedure is considered to have been incurred on the day of performance of the procedure. If a procedure is not completed in one day, the day that the procedure is completed is deemed to be the incurred day for any charges in connection with such procedure.

In the event that more than one dentist furnishes services or materials for one dental procedure, the Plan will pay no more than its obligation had one dentist furnished the services or materials.