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2017 Benefits Book

Retiree Dental Insurance

Delta Dental administers the dental plan.

Coverage (Dependent) • Retirees may keep their dental insurance for life. • No Deductibles • No UCR Charges • Open Network

Claims Dental offices should file claims with: 1-800-622-8856 www.deltadentalnc.com If your dentist does not file, claim forms are available online at www.deltadentalnc.com Retiree Dental Rates Coverage Level Option Monthly RetireeOnly $42 Retiree/Spouse $83 Retiree/Children $91 Retiree/Family $105 -Nancy Gillespie & Diane Benner, Human Resources

Limitations • If at any time the dental insurance is dropped, there will be no chance of re-enrollment. • Eligible dependent children may be covered up to age 26. • Dependents not enrolled at retirement will not be eligible for enrollment at a later date. • Notification of any change (marriage, separation/divorce, death, dependent age out) must be given to an HR Benefits Specialist within 30 days of the event. • Newborns, if not added within 30 days of birth, must be added to the plan the Open Enrollment prior to their second (2) birthday. • Most Class III expenses are limited to once every five years. • Fluoride treatments for childrenover the ageof 13arenot covered. Cost • Retirees pay the full cost of the dental insurance premium.

Effective Date • Insurance is effective the first day of the month following the month of retirement. • Insurance will be effective the first day of a month upon notification of a qualified family status change.

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www.greensboro-nc.gov