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SW Horizon May 2015
How Does the Dental Plan Work?
What Are the Benefits?
How Much Does it Cost?
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MAINTAIN HIGH LEVEL OF DENTAL HEALTH
PREMIUMS ARE PAID IN PRE-TAX DOLLARS
INSURANCE AGAINST HIGH, UNEXPECTED DENTAL COSTS (CROWNS, BRIDGES …)
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Jointly trusteed by MSBA AND MTS 26 participating divisions and
associations Each association determines the level of
benefits Level of benefits determines the premium
rates Based on ‘Before tax’ Deduction of
premiums
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LEVEL ONE- Basic Coverage (Preventative Services)
Examinations FillingsPeriodontics CleaningEndodontics ConsultationsFluoride ExtractionsX-rays Space MaintainerDrugs AnaestheticsDenture repairs
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LEVEL TWO-Major RestorativeBridges and CrownsGold fillings (if required)Partial and complete denturesReplacement of existing appliances (if 5 years old or rendered unserviceable as a result of additional work if temporary only)
Dental Implants
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LEVEL THREE-Orthodontics (dependents to age 21 or age 25 if enrolled in post secondary school)Correction of malocclusion of the teethObservation adjustmentsRepairs and alterationsAppliance serviceRecementation of bandsConsultations
The following prices have co- insurance. That is to say the plan pays the bulk of the costs and the individual pays the residual.
◦ At 80% co-insurance, the plan pays 80% and the person pays 20% of the dental costs
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Assuming 80%-level 1 , 50%-level 2, 50%-level 3, at a $1,500 combined annual maximum per person per year on all services
Estimated cost (monthly-over 10 months)
Single: $43.80 $26.28Couple: $87.60 $52.56
Family: $134.70 $80.82Note costs are pre tax
dollarsMost common Costs - Post
tax dollars9
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MANDATORY participation by all teachers NOT COVERED BY SPOUSAL GROUP PLAN
TEACHERS ALREADY COVERED BY SPOUSAL GROUP MAY OPT OUT
Teachers covered by spousal group plans may participate and will receive double coverage and pay both premiums
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If spousal group coverage is lost, or changes significantly individual MUST ENROL WITHIN 90 DAYS of loss of coverage
If spouse obtains coverage, individual MAY OPT OUT WITHIN 90 DAYS of gaining coverage
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Agreement provides for BEFORE TAX deduction of dental premiums
As is paid in pre-tax dollars, essentially the actual cost reduces to about 60% of total
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If annual salary is $80,000 per year and the dental premium is $1000 family rate the salary for participating teachers is $79,000
however, if no dental pay would have been $80,000 taxable, with Dental teacher now pay is $79,000 taxable
HOW PREMIUMS ARE PAID
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HOW PREMIUMS ARE PAID
If there is no plan, teacher receives $600 of the extra $1000, other $400 goes to tax
(Most teachers are in 39.4% tax bracket)
If plan exists teacher receives a $1000 worth of dental coverage
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In the calculation the dental reduction is based on the family rate.
If person is not family then the actual reduction is based on the applicable rate and status and the difference is added back to the pay
EXAMPLE: Actual salary for teacher covered by
spousal dental plan would be:$79,000 + $1,000 = $80,000
Actual salary for teacher in couple status:$79,000 + ($1,000 - $600)= $79,400
Actual salary for teacher in single status : $79,000 + ($1,000 - $325) = $79,675
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Salary grid is reduced by the dental premium Lower salary affects the 5 year average salary
in the pension formula Lower salary reduces the premiums and
benefits for life and disability insurance No pension reduction for opt outs Lower reduction for singles and couples Pension reduction is more than offset by value
of Dental plan and increased net income while working
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Following the initial three years, premium is based on actual utilization by the association over previous three years
Adequate reserves are maintained Surplus/Deficits belong to association, both
funded by premium decrease/increase or benefit increase/reduction. Either event is decided in consultation with Association.
Note; all negotiated salary increases are incorporated into the premium
If the Dental plan carries, the plan can be added in a new collective agreement or as an LOA
A commencement date is determined, usually coincident with a new school year, and then salary scales are adjusted to reflect the plan
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