Dental Plans

 
 

Benefits Summary Plan Description

Dental Plans

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Dental Plans

Leidos offers two different types of dental plan options. Depending on where a participant lives, he or she may be able to choose between:

For more information, download the Dental Plan Options document.

Eligibility
       
Leidos Dental PPO Plan
       
Dental Health Maintenance Organizations (DHMOs)
 
How the Plan Works
       
Continuing Coverage
   
Dental Plan Exclusions
   
Comparing the Dental Plans

 


 

Eligibility

Participation in Leidos' benefit programs is available to eligible employees and their eligible dependents:

Employees
       
Dependents
       
Registered Domestic Partners

Employees

A Leidos employee is eligible to enroll in Leidos benefit programs under the following conditions:

Type of Coverage Eligibility Requirements
  • Must be an active, regular full-time employee working at least 30 hours per week; or
  • Must be a part-time employee, regularly scheduled to work at least 12 hours per week but less than 30 hours per week; and
  • Must live in the geographic area served by a particular plan.

Consulting employees, temporary employees, leased workers, payrollees and people classified by Leidos as independent contractors are not eligible to participate in Leidos benefit programs.

Dependents

Participants may also enroll their eligible dependents in some Leidos benefit programs. Dependents that are eligible to be enrolled in these programs are:

  • The participant's legal spouse or registered domestic partner (if proof of registration with a state or local domestic partner registry is provided or if a Declaration of Domestic Partnership form is submitted).
  • Each child of the participant or registered domestic partner* younger than age 26**, including:
    • A natural child or stepchild***;
    • An adopted child (coverage begins as of the earlier of the date the child was placed in the participant's home or the date of final adoption); and
    • Any other child who depends on the participant for support and lives with the participant in a parent-child relationship, if the participant provides proof of legal guardianship.
  • Unmarried children, age 26 and older who are incapable of self-sustaining employment because they are mentally or physically disabled, as long as:
    • The mental or physical disability existed while the child was covered under the plan and began before age 26;
    • The child is primarily dependent on the participant for support; and
    • The participant provides periodic evidence of incapacity.

Participants must notify Leidos Employee Services, in writing, within 31 days of any change in dependent eligibility.

If a Participant's Spouse, Registered Domestic Partner or Dependent Is a Leidos Employee

No one can receive "double coverage" under Leidos's benefit programs. Therefore, participants may not cover a spouse, registered domestic partner or dependent child if that spouse, registered domestic partner or child is also a Leidos employee and has elected his or her own coverage.

If a participant and his or her spouse or registered domestic partner are both Leidos employees, each can choose individual coverage or one can cover the other as a dependent — but not both. If the participant has children, only the participant or spouse or registered domestic partner can choose coverage for dependent children.

Dependent Eligibility Verification (DEV) Process

As a government contractor the company is required by the Defense Contract Audit Agency (DCAA) to demonstrate that our claims for benefit costs are legitimate and ensure that we provide health and welfare benefit coverage only to eligible dependents of our employees. This ongoing verification also assures that the company does not bill the customer for medical costs associated with ineligible dependents.

To support this ongoing effort, the company maintains a Dependent Eligibility Verification (DEV) program which is administered by a third-party administrator, Budco. Throughout the year, Budco verifies that any dependent added to our plans is, in fact, eligible for coverage. This includes dependents who are enrolled as a result of new employees joining the company, a qualifying life event (i.e., marriage, birth), as well as new dependents added to our plans during the annual Open Enrollment (OE) period in the fall.

In addition to the ongoing verification process, the company is also required to perform random dependent verifications - even if an employee's dependents were previously verified. This is necessary in order to ensure that a dependent's eligibility remains unchanged.

If an employee receives a request from Budco to verify current dependents, even if the dependent has been verified before, it is critical that the request is not ignored. Failure to provide the requested documentation within the specified timeframe, will result in the dependent(s) being deemed ineligible and removed from our plans.

Covering ineligible dependents is a violation of the company's Code of Conduct and could expose the company to sanctions from the government. The company's eligibility verification process helps ensure that we are compliant with our requirements as a government contractor.

Questions about the dependent eligibility verification program may be directed to Budco at 866-488-2001, or Leidos Employee Services at 855-553-4367, option 3 or AskHR@leidos.com.

Registered Domestic Partners

The participant may enroll his or her registered domestic partner and the registered domestic partner's eligible dependent children in participating medical, dental and vision plans in which the participant is enrolled. Dependent life insurance is also available to registered domestic partners and their children.

For purposes of Leidos coverage, a registered domestic partnership is a committed same-sex or opposite-sex relationship, in which registered domestic partners:

  • Live together at the same address and have lived together continuously for at least one year;
  • Are not legally married to one another or anyone else;
  • Do not have another registered domestic partner and have not signed a registered domestic partner declaration with another within the past year;
  • Are mentally competent to consent to a contract or affidavit;
  • Are not related by blood in such a way as would prohibit legal marriage; and
  • Are jointly responsible for each other's common welfare and are financially interdependent.

If you have not registered with a state or local domestic partner registry, a Declaration of Domestic Partnership must be completed, notarized and submitted with any other required documents in order to enroll a registered domestic partner. The Declaration must be presented to insurers upon request. Contact Leidos Employee Services for additional information on enrolling with registered domestic partner coverage. The Declaration of Domestic Partnership form can be found on Prism. If you have registered with a state or local domestic partner registry, simply provide a copy of the registration document issued by the state or local registry.

Registered domestic partner coverage is different from spouse coverage. For instance:

  • Participant contributions for registered domestic partner coverage and their eligible children must be paid on an after-tax basis;
  • The value of benefits provided to a registered domestic partner and/or his or her eligible children is considered taxable income. As a result, the Leidos employee must pay any state, federal, FICA and other applicable tax withholding in the form of imputed income. This amount is based on the value of the coverage Leidos provides to the partner.


 

How the Dental Plans Work

Leidos offers participants a choice when it comes to choosing the type of dental plan that works best for the participant and his or her family.

With the Leidos Dental PPO Plan, a participant can use any dentist he or she wants. However, when a participant uses dentists who participates in the Delta Dental PPO plus Premier network in 2018, he or she will receive a higher level of benefits and pay lower out-of-pocket costs. This is because network providers have agreed to charge lower, negotiated fees for services. When a participant uses dentists outside the network, he or she will receive a lower level of benefits and pay higher total out-of-pocket costs.

A Dental Health Maintenance Organization (DHMO) works just like a health maintenance organization, or HMO. There is no deductible, and there are no claim forms to file. Participants must choose a network provider, who will coordinate and provide dental care services at a fixed cost. If a participant does not coordinate his or her care through the primary care dentist, the plan will not pay benefits. DHMOs are available only in areas where there are participating dentists.

Please carefully review the sections pertaining to what the dental plans will and will not cover to find information on the dental plan exclusions. Additionally, the individual dental plan carriers should be contacted for information on the specific exclusions for dental work in progress.


 

Dental Plan Exclusions

Contact the individual dental plan carrier for specific exclusions pertaining to dental work already in progress.

Aetna DMO Plan

All charges for crown and bridge are per unit. There will be an additional patient charge for the actual cost of gold/high noble metal for some procedures. Prosthetics/Dentures: Benefit includes relines, adjustments, rebases within 1st six months. Adjustments to dentures that are done within six months of placement of the denture are limited to no more than four adjustments.


 

Continuing Dental Coverage After Plan Coverage Ends

A federal law called the Consolidated Omnibus Budget Reconciliation Act (COBRA) enables a participant and his or her covered dependents to continue dental insurance if their coverage ends due to a reduction of work hours or termination of employment (other than for gross misconduct). Federal law also enables a participant's dependents to continue dental insurance if their coverage stops due to the participant's death or entitlement to Medicare; divorce; legal separation; or when the child no longer qualifies as an eligible dependent. The participant must elect coverage according to the rules of the Leidos health care plans. Continuation is subject to federal law, regulations, and interpretations.

For more information about participants' rights under COBRA, the participant should refer to Continuing Health Care Coverage Through COBRA in the Plan Information section.

Participants in a DHMO should refer to that plan's certificate of coverage booklet for more information.