You have two dental plans from which to choose ... an HMO and a PPO. Both plans provide excellent benefits and give you access to SafeGuard's extensive provider networks throughout Texas.
Select the plan that best meets your needs ... and then make sure that you use your benefits. Prevention is the best medicine. See your dentist at least twice a year - get your teeth cleaned regularly - catch the little problems before they become bigger and you will save money and your smile.
Here is a side-by-side comparison of the two plans offered by the City.
| |
SGX185
Dental HMO |
CitiDent
Dental PPO |
| 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 realize potential savings by receiving care from a SafeGuard contracted PPO dentist. |
| Specialty Care |
Provided at the co-pay listed in your Schedule of Benefits. If unable to provide the needed procedure, your SafeGuard general dentist will refer you directly to a network specialty care dentist. There is no need to get pre-approved by SafeGuard. |
Provided at the co-insurance listed on your Summary of Benefits. You may see any licensed dental care professional but could save on costs when receiving care from a SafeGuard contracted provider. |
| Calendar Year Deductible |
None |
$50 per person
$150 per family |
| Calendar Year Maximum |
None |
$1,200 |
Co-payments &
Co-insurance |
Co-payments are set by procedure and all covered procedures are listed on the Schedule of Benefits |
Preventive : 100%
General: 80%
Major: 50%
|
| Orthodontic Services (Braces) |
Co-payments by type of service - $1695 for comprehensive treatment (adult & child available)
|
$1500 Lifetime Maximum, no Deductible (ages 6-19) |
| Waiting Period |
None |
|
This is a summary only; for more information regarding the plans, you will find full benefit information later in this section of the website.
Enrollment Instructions
During enrollment, choose one of the following plans for your dental benefit coverage:
1. SafeGuard DHMO Plan - SGX185
If you choose to enroll in the dental HMO plan...
- Remember to select two dentists from the SafeGuard directory for you and each of your enrolled dependents.
- Write the Facility Number of each dentist in the space allotted on your Provider Selection Form (found in your enrollment kit).
- To find a dentist in your area, click on the "Provider Directory" button.
- A Schedule of Benefits with co-payments and Exclusions & Limitations is included below.
- Your Evidence of Coverage provides information on how to access care on this plan and should be reviewed before you enroll.
If, after reviewing the plan documents, you have any questions, our Customer Service Representatives will be happy to assist you.
800.880.1800
7 am - 8 pm, Mon-Fri.
2. CitiDent PPO Plan
If you decide the PPO plan is right for you, there is no need to "pre-select" a SafeGuard dentist . You can receive treatment from any dentist, but you may 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.
- After you enroll, you will be sent a Certificate of Insurance (COI) along with an ID card. This COI provides more information on your benefits and how to access care on this plan. Be sure to review it prior to the first appointment with your dentist.
If, after reviewing the Summary of Benefits, you have any questions, our Customer Service Representatives will be happy to assist you.
800.880.1800
7 am - 8 pm, Mon-Fri.
Have a question? You can email us at the City's dedicated email address and we will respond in 24 hours.
