Tuality Health Alliance
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Dental Plan Options

Your dental plan options are:

Preventive Plan

Under the Preventive plan, you may receive care from any licensed dentist. After you pay a $50 annual deductible (per person), the plan will pay a percentage (coinsurance) of covered expenses, up to $1,500 per person per year. There is no deductible required for diagnostic/preventive care.

Incentive Plan – Only for those enrolled on 12/31/10

The Incentive Plan is no longer available as an option for Tuality employees and their covered family members. If you were enrolled in the Incentive Plan on December 31, 2010, you may continue to be covered in this plan. If you elect to opt out of the Incentive Plan and into the Preventive Plan, you will not be allowed to move back to the Incentive Plan.

Highlights of Dental Plan Options

Plan Features Preventive Plan Incentive Plan*
How the plan works Plan pays benefits for covered services from any licensed provider. Plan pays benefits for covered services from any licensed provider.
Annual deductible/calendar year $50/person waived for diagnostic/preventive care. None.
Covered services
Diagnostic/Preventive care, including routine exams, cleaning, x-rays. Yearly routine exams and cleanings allowed twice a year: 0% (deductible waived.) Your costs decrease each calendar year you receive care: first year: 30%, second: 20% third: 10%, thereafter: 0%.
Restorative/Oral Surgery including fillings, extractions, root canal and periodontic services: 20% after deductible. Your costs decrease each calendar year you receive care: first year: 30%, second: 20% third: 10%, thereafter: 0%.
Restorative/Prosthodontics, including crowns, inlays, onlays, bridges: 50% after deductible. 50%.
Maximum annual benefit: $1,500 per person. $1,500 per person.
Orthodontia Services (Adult/Children): 50%, no deductible. Not covered.
Orthodontia lifetime benefit: $1,500 per person. Not covered.

*closed to new enrollment.

Moda Health Network

While both of our Dental plans allow you to seek treatment from any licensed dentist, you will experience lower out-of-pocket costs when choosing a dentist who participates in the Moda Health network. These dentist have agreed to NOT bill patients for costs that exceed the amounts agreed upon in their contract with Moda Health.

To find a Moda Health dentist, call (503) 243-4494 or visit www.modahealth.com.

Waiving Coverage

You may elect to opt out of dental coverage for you and/or your spouse/domestic partner or children. You and your eligible spouse/domestic partner or children will not receive dental benefits from Tuality, and a cash alternative will be added to each of your paychecks.