The Dental Benefits Plan described is made available to eligible employees.
Hudson Valley Community College's Dental Benefits Program has been designed to encourage you to maintain good dental
care while keeping dental care expenses at a minimum. By visiting your dentist for check-ups
on a regular basis (at least once a year) and receiving prompt treatment of small disorders
when they are first discovered, you will be avoiding more serious dental problems from
developing at a later date. This makes good sense from both a health and financial standpoint.
The Dental Benefit Program allows you complete freedom of choice in the selection of any
In addition, you are not required to submit to a preliminary examination in order to establish
your eligibility or the Dental Benefits Program.
To determine if you are eligible for this Plan, please contact the Office of Human Resources.
Benefits are available to all eligible employees on the effective date of the Dental Plan. The
Office of Human Resources will determine your eligibility.
New employees become eligible on the first day of the seventh month following the date of
BASIC SCHEDULE OF ALLOWANCES
Schedule of Allowances is published on the Office of Human Resources website. For each
dental procedure listed, the plan will pay the Benefit Payable or the actual charge, whichever is
TERMINATION OF BENEFITS
Dental benefits will cease on the same day of the month you are removed from the payroll, or if
you fail to make the required contributions, if any, toward the cost of your benefits. There are
no benefits for dental services performed after termination of coverage.
As of January 1, 2015, the College's dental plan is administered by Delta Dental.
Please visit their website at www.deltadentalins.com to find a listing of participating
dentists. Select" Find A Dentist", and choose Delta Dental PPO as the network. By
using a plan participating dentist, you will be able to minimize any out-of- pocket costs
that may be required for your dental services.
The Dental Benefits Plan will not allow benefits for the following:
- Loss or theft of a denture.
- Extra duplicate prosthetic device.
- Injuries, diseases or conditions, the treatment of which is available without cost to the
person treated under the laws enacted by the legislature of any State or the Congress of
the United States (such as Worker's Compensation, Veteran's Compensation, etc.)
- Cosmetic dentistry.
- Oral hygiene, dietary instructions, or education programs.
- Any charge for failure to keep a scheduled appointment.
- Any charges for appliances or restorations, other than full dentures, whose purpose is to
alter vertical dimension, stabilize periodontically involved teeth or restorative
- Any charge for completing a claim form.
- Services or supplies which do not meet accepted standards of dental practice or are
experimental in nature.
- Dental disease or defect incurred or resulting from war, declared or undeclared, military
or naval service to any country, riot, civil disorder, insurrection or while committing a
- Dental mechanic or denturist, unless practicing according to applicable dental practice
acts and related statutes.
- Any service or appliance received from a dental or medical department maintained by
an employer, a mutual benefit association, labor union, trustee or other similar person
- Any service unless rendered in connection with the care of an employee by a duly
licensed dentist, and any service or appliance for which the patient incurs no dentist's
- Any type of service or appliance not described in the Plan or in any Rider modifying the
CLAIM ADMINISTRATION and QUESTIONS
For questions regarding payment of claims, processing, etc. enrollees can either visit
Delta Dental's website at www.deltadentalins.com and create a log-in, or can contact
Delta Dental's customer service at 1-800-932-0783.
If the dentist you go to is participating in the Dental Benefits Plan, it will be required
that you info1m the Participating Dentist of your enrollment in the College's Plan.
Notification will be accomplished by presenting the Dental Benefits Identification
Card that has been issued to you.
COORDINATION OF BENEFITS
If you are entitled to receive benefits from another group plan, benefits under this plan will be
coordinated with the benefits from any of your other group plans so that up to 100% of the "allowable expenses" incurred during a calendar year will be paid by the plans.
An "allowable expense" is any necessary, reasonable, and customary item of expense covered
in full or in part under any one of the group plans involved.
A "Plan" is considered to be any group insurance benefits or other arrangement of benefits for
individuals in a group which provides dental benefits or services on an insured or an uninsured
The College reserves the right to obtain and exchange benefit information from any other
insurance company, organization, or individual to determine the applicability of the
Coordination of Benefits provisions. When an overpayment has been made, the College has
the right to recover the excess amount from the individual, insurance company, or organization
to whom payment has been made.
In order to obtain all of the benefits available, you should file claims under each plan.