Benefits - Dental Plan - SEBF Dental and Vision Plan

Benefits

SEBF Dental and Vision Plan

(Service Employees International Union (SEIU) bargaining unit employees only)

SEBF Dental Plan

SU offers two subsidized dental options through SEBF for all benefits-eligible SEIU employees: the Basic Plan and the Comprehensive Plan.

The Basic Plan includes cleanings, X-rays, extractions, periodontics, fillings, oral surgeries and endodontics.
The Comprehensive Plan covers everything that the Basic Plan covers plus prosthetics such as crowns/caps, bridgework partial and full dentures.

All covered procedures are paid in full when you choose a participating dentist. SEBF allows you to choose any licensed dentist; however, reimbursement will be made according to the SEBF Schedule of Benefits. You will be responsible for any remaining balance.

For more information regarding the SEBF plans see the SEBF Schedule of Benefits brochure.

Enrollment in the SEBF Dental Plan is a one-year commitment.

SEBF Dental and Vision Plan

You must enroll in one of the two SEBF Dental Plan options (described above) in order to enroll in the SEBF Vision Plan. Vision is not available as a separate option.

Vision benefits may be used once every 24 months and may NOT be split between In-Network and Out-Of-Network providers.

Your enrollment in the combined SEBF Dental and Vision program is a one-year commitment; however, vision benefits may be used only once every 24 months.

Contributions

Most premiums are paid through pre-tax payroll deductions.
Qualified same-sex domestic partner premiums are paid on an after-tax basis.
SU contributes $100 per employee towards dental coverage. If you waive all dental coverage, SU will contribute $100 to a Health Care Flexible Spending Account.

SEBF Dental With or Without SEBF Vision Rates*
2009 Monthly Rates	SEBF Dental Basic Plan	SEBF Dental Basic Plan Plus SEBF Vision	SEBF Dental Comprehensive Plan	SEBF Dental Comprehensive Plan Plus SEBF Vision
Employee	$ 7.73	$10.55	$12.28	$15.10
Employee +1	$18.46	$24.79	$26.71	$33.04
Family	$28.48	$34.81	$38.26	$ 44.59

* Rates listed here are based on the 12-month calendar year. Actual deductions from each
paycheck will vary depending upon your deduction cycle.

Helpful Links

SEBF

EBS Benefit Solutions

Health Care Flexible Spending Account

Need Help? Contact SEBF for claim forms or for other information.

tmcmanus@sebf.org

dpolitis@sebf.org

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The web pages summarize your Syracuse University benefit options. Every effort has been made to ensure this information is accurate. However, the programs are governed by legal documents and insurance contracts. If there is any difference between the information on these web pages and the official documents and contracts, the official documents and contracts will rule. Our benefits are governed by current laws and operated according to Internal Revenue Service (IRS) regulations. We will notify you if changes in plans are necessary to comply with the law or with IRS regulations.
Employees electing to participate in the SU benefit plans are bound by the terms of the governing Plan documents. If you have any questions regarding the plans, you may request a copy of the Plan document from the Plan Administrator by contacting the HR Service Center at the number indicated at the end of this page.
As is the case with all benefits offered by SU, (1) the Plan Administrator has the discretionary authority to interpret the terms of the Plan and such interpretation will be binding on all interested parties to the fullest extent permitted by law, and (2) the University reserves the right to modify or terminate the Plan at any time.