2018 EAA Dental/Vision/Chiropractic Program

Open Enrollment: October 1, 2018 – October 31, 2018

One of the benefits offered to members of EAA is a Dental/Vision/Chiropractic Plan. EAA voluntary dues members have the choice of enrolling in one of the two plans EAA offers (in lieu of the City of LA Dental Plans). In our effort to bring you the most service for your benefit dollar, we are offering you dental and vision benefits through United Concordia and MES. As for 2019, EAA is offering the same three options from 2018. This dental benefit includes a Vision and Chiropractic Plan, while the City offers only Dental coverage.

Dental is offered by United Concordia. Vision is offered by Medical Eye Services. Chiro is offered by Landmark. These are the costs:

 Monthly PremiumMonthly SubsidyMonthly Employee Deduction*
HMO -
Employee
$61.54$44.60$16.94
HMO -
Employee + 1
$69.49$44.60$24.89
HMO - Family$80.08$44.60$35.48
Basic PPO -
Employee
$87.04$44.60$42.44
Basic PPO -
Employee + 1
$156.42$44.60$111.82
Basic PPO -
Family
$253.45$44.60$208.85
High Option PPO -
Employee
$97.34$44.60$52.74
High Option PPO -
Employee + 1
$175.38$44.60$130.78
High Option PPO -
Family
$283.61$44.60$239.01

*The City will add $0.09 to each employee’s bi-weekly deduction, which is payable to the City as a collection fee.

THIS NEW PLAN WILL TAKE EFFECT JANUARY 1, 2019

VISION COVERAGE is our main improvement over the City’s program, which only has Dental. A family that needs eyeglasses or contact lenses can save hundreds of dollars a year with our program. You get these benefits no matter which option you choose. Benefits are offered through Medical Eye Services (MES):

Frequency is 12 months for exams, 12 months for lenses and contact lenses, and 24 months for frames.

BenefitIn-NetworkOut-of-Network
Examination Copay$5N/A
Materials Copay$10N/A
ExamCovered in Full$45 Allowance
Single Vision LensesCovered in Full$32 Allowance
Bifocal LensesCovered in Full$55 Allowance
Trifocal LensesCovered in Full$65 Allowance
Lenticular LensesCovered in Full$80 Allowance
Contact Lenses (retail allowance)
Elective$110 Allowance$98 Allowance
TherapeuticCovered in Full$210 Allowance
Frame (retail allowance)$120 Allowance$66 Allowance

CHIROPRACTIC/ACUPUNCTURE SERVICES:

30 visits per year at a $20 Copay. Must use the Landmark Network. Herbal therapies: $5 copayment per bottle, $500 annual maximum benefit. No MD referral required. You get these benefits no matter which dental option you choose.

DENTAL – CHOOSE ONE DENTAL OPTION FROM OUR CHOICE OF THREE:

DENTAL OPTION #1 – DENTAL HMO

People choose HMO’s because they have the lowest out-of-pocket costs, and they have no limit on the annual benefit amounts available to you. But you need o use an in-network dentist.

Routine Diagnostic and Preventative Care is free. There is no charge for an Office Visit. Much basic care is available at no charge. Once you are a member, you may register with United Concordia. Log into My Dental Benefits and review your claims, coverage, and print additional ID cards at any time.

For people who are okay with seeing a United Concordia HMO dentist and who need to save the most money on dental care, this is a great choice!

DENTAL OPTION #2 – BASIC PPO

The main reason people choose a Dental PPO is that they want maximum freedom to pick their Dentist. If you already have a Dentist you like and he/she will not take United Concordia HMO insurance, then a PPO is for you.

You will save the most money if you use a Dentist, who participates in the United Concordia PPO Dental network because they are required to give you low, discounted prices when you receive care.

The Deductible is $50 per person with a $150 family maximum. The annual maximum benefit is $1,500 (In or Out-of-Network). Most Preventative and Diagnostic care is free and Basic Restorative Care (Fillings, Root Canals, Root Planning & Scaling, and Crown Repairs) is covered at 90% after the deductible (In-Network). Major Restorative Care (Crowns, Inlays, Onlays, Dentures, Bridges) is at 60% (In-Network). Orthodontia is covered for children only, at 50% with no orthodontia deductible. Once you are a member, you may register with United Concordia. Log into My Dental Benefits and review your claims, coverage, and print additional ID cards at any time.

DENTAL OPTION #3: HIGH OPTION PPO

For those who may have serious dental care needs, this is a “Cadillac” plan. The Deductible is $25 per individual, $75 maximum Deductible per family. There is a $2,000 annual maximum benefit in-network/$1,500 out-of-network. Preventative, Diagnostic, and Basic Restorative Care are covered at 100% in-network. Major Restorative Care is covered at 80% in-network and Orthodontia for Children only at 50% with a $2,000 Lifetime Maximum. Once you are a member, you may register with United Concordia. Log into My Dental Benefits and review your claims, coverage, and print additional ID cards at any time.

ENROLLMENT PROCEDURES

To enroll in (0r make changes to) the EAA Dental/Vision/Chiro Plan, employees must select the EAA Program in the City’s selection process during open enrollment. The plan (or changes) will not take effect until January 1, 2019. The following steps will assist you during open enrollment period:

  1. If you are not currently enrolled in a dental plan and would like to become a member of an EAA Dental Plan:
    1. Call the EAA office to confirm your eligibility and request a dental package to enroll.
    2. Login to MyFlexLA and follow the instructions to change dental plans.
  2. If you currently belong to one of the City Dental Plans and wish to enroll in one of the EAA plans:
    1. Call the EAA office to confirm your eligibility and request a dental package to enroll. Complete the enrollment application and return to the EAA office by October 31, 2018.
    2. Log into MyFlexLA and follow the instructions to dis-enroll from City’s plan.
  3. If you are a current EAA Dental Plan member:
    1. You do not need to complete a new enrollment application. You may change your family enrollment at this time (add or delete dependents) and new enrollment application must be completed and return to the EAA office by October 31, 2018.
  4. If you now have EAA Dental and wish to enroll in the City Dental Plan:
    1. Log into MyFlexLA and follow the instructions to change dental plans.
    2. Call the EAA office to notify them of your enrollment in the City’s plan.

If you have any questions regarding the above enrollment procedures, please contact the EAA office at (213) 620 – 6920 x 0 or contact Helen.Georgeson@lacity.org or Maria.Lopez@lacity.org at the Employee Benefits Division by October 31, 2018.

If you do not have Internet access, you may contact Helen Georgeson at (213) 978 – 1588 or Maria Lopez at (213) 978 – 1584.