Dental and Vision Preview
Information on the new federal dental and vision benefits has been slow in coming. But now that the Office of Personnel Management awarded contracts to a handful of insurance companies -- after yanking them once -- details are starting to trickle in.
Dental and vision insurance will be available starting Nov. 13, when open season begins for all federal insurance options and full details will be available. The benefits are not subsidized by the government, but OPM said it used the mass numbers of federal employees to negotiate lower rates for participants. And government employees can pay for the benefits using pretax dollars.
OPM asked companies to fulfill basic requirements to win the contract, but each company will differ in specific offerings. That means participants will have to do more homework this fall to choose the best plan. OPM is requiring each insurer to offer brochures in the same format for easy comparison during open season.
In the meantime, here's some information for a head start. Contracts have not been finalized, so some information could change by November.
All the plans offer three enrollment options: yourself, yourself plus one, or yourself plus family.
For dental coverage, the Government Employees Hospital Association will offer a standard and a high option plan. One will have a presumably higher premium and no co-pay, while the other will have a $10 co-pay for visits to the dentist. There will not be a waiting period, meaning the moment you sign up, you could use the benefit. The one exception -- and this holds true for all insurers Government Executive talked to -- is orthodontia. GEHA has a two-year waiting period before that benefit kicks in.
GHI, a New York area regional dental provider, will offer only one option. The deductible -- $50 for individuals and $150 for families -- will apply to bigger services like root canals and will not cover routine teeth cleanings, for example. GHI has a one-year waiting period for orthodontia.
United Concordia, which provides insurance for the Defense Department's massive TRICARE program, is offering one option as well. There will be a deductible, but the insurer declined to specify the amount. There will be a two-year orthodontia waiting period.
Aetna also will offer just one option, but there's a twist. Aetna, which provides general medical insurance under the Federal Employees Health Benefits Program, already offers some dental coverage in that plan. Supplemental dental coverage, if an employee signs up with Aetna or another company with similar offerings, will fit with that. There will be a 24-month orthodontia waiting period and no deductible.
CompBenefits, a regional carrier in 23 states, will offer one option for its dental coverage. There will be no deductible and generally, there will not be a waiting period, but participants will have to go to dentists in the network for coverage. CompBenefits said its focus will be on providing the most simple, easy-to-follow plan.
Two companies -- Triple-S, which offers dental insurance in Puerto Rico, and MetLife -- could not be reached by Wednesday.
As for vision benefits, a spokeswoman for Blue Cross Blue Shield said the insurer would not release any information prior to open season because the contract is not finalized.
But the other two companies -- Spectera Inc. and Vision Service Plan -- provided some details.
There will be an in-network as well as an out-of-network benefit for Spectera. The company will not have any deductibles, but will require co-payment. There will be exam, frame, lens and contact lens benefits. There won't be a waiting period for benefits.
VSP, which has about 23,000 doctors on its network, said it will require modest co-payments. The amounts have been determined, but the insurer declined to publicize them at this time. The benefit will cover exams as well as eyewear.
Most of these companies are launching Web sites to provide information on their new federal plans.