Depending on your eligibility status, you have the opportunity to choose one plan from the three offered by Pasco County Schools. All three plans provide excellent benefits and access to highly-qualified dental care professionals.
Here's a side-by-side comparison to give you an overall idea of how each plan works.
| |
SGC1027
Dental HMO |
SHC576 & SHC581*
Dental PPO |
| |
In-Network |
Out-of-Network |
| Access to Care |
Benefits provided through a network of dentists.
Employee and dependents must choose a SafeGuard contracted dentist at enrollment.
|
You may receive treatment from any licensed dentist or receive potential savings by receiving care from a SafeGuard contracted dentist. |
| Calendar Year Deductible |
None |
$75 per person
$225 per family |
$75 per person
$225 per family |
| Calendar Year Maximum |
None |
$1,500 |
$1,500 |
Co-payments &
Co-insurance |
Co-payments are set by procedure and all covered procedures are listed on the Schedule of Benefits |
Preventive : 100%
General: 90%
Major: 60%
|
Preventive : 80%
General: 80%
Major: 50%
|
| Non-surgical TMJ |
Not Covered |
50% up to $1000 Calendar Year Maximum |
50% up to $1000 Calendar Year Maximum |
| Adult & Child Orthodontic Services (Braces) |
Co-payments by type of service - $1695 for comprehensive treatment |
$1000 Lifetime Maximum after Deductible |
$1000 Lifetime Maximum after Deductible |
| Waiting Period |
None |
SHC576 - No waiting period
SHC581* - 12 month waiting period on Major Services & Non-surgical TMJ
|
This is a summary only; for more information regarding the plans, you will find full benefit information on the Pasco Employee Benefits Department website.
*The SHC581 is the "Opt Out Only Plan".
Enrollment Instructions
During enrollment, choose one of the following plans for your dental benefit coverage:
1. SafeGuard DHMO Plan - SGC1027
If you choose to enroll in the dental HMO plan...
- Remember to select a dentist from the SafeGuard directory for you and each of your enrolled dependents.
- Write the Facility Number in the space allotted on your enrollment form.
- A Schedule of Benefits with co-payments and Exclusions & Limitations is included below.
- Your Evidence of Coverage provides information on how to get the most from your SafeGuard dental HMO plan.
If, after reviewing the plan documents, you have any questions, our Customer Service Representatives will be happy to help you.
800.880.1800
8 am - 9 pm, Mon-Fri.
2. SafeGuard PPO Plan - SHC576 or SHC581 (Opt Out Only Plan)
If you decide the PPO plan is right for you, there is no need to "pre-register" with a SafeGuard dentist - you can receive treatment from any dentist, but you will save on out-of-pockets costs with a SafeGuard contracted dentist.
- Your Summary of Benefits includes the information on how payment is calculated for these plans and is included below along with the Exclusions & Limitations.
- A copy of the Certificate of Insurance you will receive with your ID card is also available below for your review.
If, after reviewing the plan documents, you have any questions, our Customer Service Representatives will be happy to help you.
800.880.1800
8 am - 9 pm, Mon-Fri.
