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.

Leidos Dental PPO Plan
       
Dental Health Maintenance Organizations (DHMOs)

How the Plan Works
       
Continuing Coverage
   
Dental Plan Exclusions
   
Comparing the Dental Plans



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 participate in the Aetna PPO network, he or she will receive a higher level of benefits and pay lower out-of-pocket costs. This is because Aetna network providers have agreed to charge lower, negotiated fees for services. When a participant uses dentists outside the Aetna 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.