Vision A
TRUE or FALSE: Employees automatically receive vision coverage when you enroll for medical coverage but cannot enroll in the vision plan if they waive their medical plan
"FALSE"
Addtnl: You can enroll in Vision if you do not enroll in medical but there will be a per paycheck amount you are responsible for.
TRUE or FALSE: You can enroll in SAP dental coverage even if you do not enroll in SAP medical coverage.
TRUE
When will employee be eligible for the vision plan?
First of the month following the hire date
Name of dental plan provider
"Delta Dental"
Addtnl: Group name - SAP America
Group number - 18929
www.deltadentalins.com/welcome
1-800-932-0783
Employees must be working _________ or more to be eligible for vision and dental benefits
24 hours per week
All claims for reimbursement must be filed within ______ of the date services were completed
"Six months"
Addtnl: Send a copy of the itemized bill(s) to VSP along with a claim form which can be conveniently located on the VSP website. Mail information and receipts to:
Vision Service Plan
Attention: Claim Services
P.O. BOX 385020
Birmingham, AL35238-5020
How many ID cards employee receive?
Two ID cards
Addtnl: ID cards will display
This ________ benefit that is available to anybody enrolled in the vision plan and will allow employees to get more than one service in a year
"Buy up"
Addtnl: Buy-Up option will have a per paycheck deduction whether you are covered on a medical plan or not. Rates are available on the Total Rewards North America benefits website https://sapnorthamericabenefits.com/en/public/welcome
Do employees need to elect the same coverage level for medical and dental coverage?
No, you do not need to elect the same coverage level for your medical and dental coverage.
Addtnl: For example, you may enroll for Employee Only medical coverage (e.g., your spouse is covered for medical under his or her employer’s plan) but elect Employee + One dental coverage. Please check your dependents carefully on your dental plan in Benefitfocus as they do not carry over from your medical plan.
Can I make changes to my dental plan anytime?
No. Outside of the open enrollment period election/changes can only be made within 31 days of your hire or a qualified life event.
TRUE or FALES: If you visit an out-of-network doctor, your out-of-pocket costs can be higher. You will have to pay the full amount for care and/or corrective eye wear at the time of the purchase then submit a claim for reimbursement.
"TRUE"
Addtnl: If you visit an out-of-network doctor, Vision Service Plan (VSP) will only reimburse you up to the amount allowed by the plan and you will be responsible for the difference.
TRUE or FALSE: You can see any dentist you choose with dental plan.
"TRUE"
Addtnl: Though it provides a higher benefit when you seek in-network coverage. To verify if a provider is a member of the network, you should check Delta Dental's website. If your dentist is not currently participating in the network, but would like to know more about the advantages of participation, please ask him or her to call Delta Dental.
Out-of-network reimbursement is based on the maximum allowable charges (MAC). If you decide to go to an out-of-network dentist, you are responsible for any amount charged by the dentist in excess of the MAC for that service. Therefore, utilizing services from an out-of-network provider may cost you more out of pocket in the future.
All participating providers are required to complete and file claims on behalf of the patients. Non-participating providers are not required. Paper claims can be mailed to Delta Dental of Pennsylvania PO BOX 2105 Mechanicsburg PA 17055-6999
TRUE or FALES: Laser vision correction procedures are NOT reimbursable expense under the plan.
"TRUE"
Addtnl: However, laser vision correction procedures are offered at a discount through Vision Service Plan (VSP)’s network of contracted facilities and doctors. You must be pre-screened and referred by a VSP network doctor to qualify for the discount.
TRUE or FALSE: You are covered for one cleanings per year and covered 50% for diagnostic and preventive care with deductible.
TRUE or FALSE: You are covered for three cleanings per year and covered 100% for diagnostic and preventive care with no deductible.
Addtnl: The plan also provides coverage for posterior composites; contact Delta Dental for more information.
TRUE or FALSE: It may take approximately 2-3 weeks from when your elections/changes are submitted for Delta Dental’s system to be updated.
"TRUE"
Addtnl: If Delta Dental does not yet have you in their system and you or a dependent need dental services, you will need to pay for the services and submit a claim form to Delta Dental for reimbursement of eligible expenses.
Medical plans where vision coverage is included when enrolled to these plans
Aetna PPO85, CC90, CC80, and Kaiser medical plan
I am currently receiving orthodontic treatment through another dental plan, will I receive the maximum coverage?
If you are currently receiving orthodontic treatment through another dental plan, your maximum benefit under the new dental plan may be prorated based on when you started treatment. Contact Delta Dental for more information.
Addtnl: Dental plan has no deductible
Will I be reimbursed for more than one pair of glasses at a time under my Vision Plan?
No. The Vision Plan only pays for lenses every 12 months and new frames every 24 months. However, you may receive 20% off the discounted price of a second pair of prescription glasses if you purchase the second pair glasses from the same doctor within 12 months of your covered examination.
I need an additional card aside from what is initially given to me for my dental plan. Can I have extra cards?
Yes, you will have the ability to print temporary or additional ID cards should you need them. To do so, log on to the Delta Dental Web site www.deltadentalins.com/welcome
Employee's dental plan Member ID
Employee's SSN
Name of vision plan provider
"Vision Service Plan"
Addtnl: Group name - SAP America
Group number - 12222208
Contact Number - +1 800-852-7600
Website - www.vsp.com.
I enrolled my 18 year child and spouse in the dental plan but why they aren't still covered? I cannot see them on my online account on the delta dental website.
Dependent children 18 or older must register separately, and will have access to only their data. Your spouse must also register separately, and will have access to his/her data and any minor children's data. Any person 18 years or older will not appear on the employees logon account. Their dependents (18 or older) will need to create their own User ID and password to review their account.
Which is correct:
A. Show vision ID card to obtain services when you visit a participating in-network provider.
B. Identify yourself as a Vision Service Plan (VSP) member when you visit a participating in-network provider.
B. Identify yourself as a Vision Service Plan (VSP) member when you visit a participating in-network provider.
Give at least 4 out of 7 qualifying conditions for filing Smile for Health Wellness
The Pregnancy Benefit in the dental coverage provides ____________ and additional periodontal (gum disease) benefits during pregnancy
"One extra dental cleaning"
To sign up for Smile for Health – Wellness and the Pregnancy Benefit:
1. Visit www.deltadentalins.com/welcome
2. Sign in to My Dental Benefits (Or, create an account)
3. Click My Oral Health
4. Follow the prompts to verify or report your medical condition