2023-24 Plan Year- Annual Enrollment:

Closing June 1, 2024

Every Active Member who would like to receive reimbursement benefit for the plan year needs to complete the online enrollment. This is an annual requirement.

DCUE Dental Plan Year: September 1 - August 31

ENROLLMENT DEADLINE is a hard deadline.

Claims received by an individual who has not enrolled will be denied.

There is not an option to appeal a claim denial based on lack of enrollment.

You can check your enrollment status by logging into your Dental Members tab and looking for a green thumbs up or a red thumbs down alongside the Open Enrollment picture.

Log into your Dental Members tab here

New Hires for 2023-24 School Year 

DCUE Dental receives a listing from the District Office of your employment and eligibility for DCUE Dental Reimbursement.

You will receive a Welcome Email from DCUE Dental about completing your online enrollment. You can not access the system to enroll until you have received this email from DCUE Dental.

Welcome emails will start to go out after August 1, 2023.

Due to delayed communication you may not receive information about enrollment right after you are hired. Please reach out if you have not heard from DCUE Dental by September 1, 2023.

You must complete the Online Enrollment to get signed up and receive reimbursment for your dental expenses.

New hire/member dental coverage begins at the start of the new plan year; September 1. If you are hired after September 1, your dental coverage begins when the District begins to cover your premium and you have enrolled.

 For more information click here: 

 www.dcue.org/dcue/areas/dental/downloads/New_Hire_Information_Online.pdf

Orthodontic Benefits

Individuals up to age 26 can receive $2000 towards orthodontic treatment. The $2000 benefit is separate money from the dental benefit an individual can receive, it is reimbursed at a 100% match to your payment made and is a lifetime maximum.

As of September 1, 2020 DCUE Dental Reimbursement Fund, Board of Trustees placed an age cap for orthodontic reimbursement. The Orthodontic benefit will end the last day of the month, which you or your dependent turns age 26.

Orthodontic claims are based on date of payment for processing purposes and must be received within the appropriate plan year to receive reimbursement.

Orthodontic Info: https://dcue.org/dcue/areas/dental/downloads/Orthodontic_Info.pdf

DCUE Dental Fiscal Year

The plan year runs from September 1^st – August 31^st

Dental treatment claims are processed based on Date of Treatment, Orthodontic treatment claims are processed based on Date of Payment. Be sure to submit your claims within the appropriate plan year and time guidelines. For more plan details click on the link below:

https://www.dcue.org/dcue/areas/dental/downloads/Plan_at_a_Glance.pdf

2022-2023 Plan Year: September 1, 2022-August 31, 2023

2023-2024 Plan Year: September 1, 2023-August 31, 2024

Claim Submission/Filing

Paper Claim Forms

Claim forms, with supporting documentation, can be sent to the DCUE Dental office through District Mail, US Mail or dropped off. 

Claim forms should be completed in full by the member.

Supporting documentaiton must include: Provider Name & Address, Patient Name, Date of Service completed, Code & Description of Services Completed, Charges for services, Payment made via cash, check, etc., Date & Amount of Payment, payment must equal charges, please look at the amounts on your statement to make sure they balance.

If you have insurance involved with your claim submission you are required to send a copy of the insurance Explanation of Benefits (EOB) as part of your supporting documentation.

If there is a Section of your claim form that is incomplete and/or supporting documentation details that are missing your claim will be returned with a slip requesting what is required.

During the school year claims are returned to your school mailbox via District Mail, during summer they will be mailed to your home address on file.

For claim filing directions click on the link below: www.dcue.org/dcue/areas/dental/downloads/Claim_Filing_Information.pdf 

Proof of Payment

To help avoid claim returns be sure you are including a payment receipt with your claim submission.

The Plan reimburses the Member directly; therefore your services need to be paid for prior to you being reimbursed.

Payment(s) must match up to the total charges listed for a specific date of treatment or the Patient Responsibility amount, if other insurance is involved. Services must be paid for in full prior to being reimbursed. Contact DCUE Dental for special circumstances such as payment plans for large dollar treatments.

Proof of Payment can be a computer statement or a separate receipt. Details of your payment should include dollar amount of payment, how payment was made, date payment was made and for which patient payment applies to. We do not accept “paid” stamped or handwritten on the statement and we do not accept a copy of your check.

Late Claims

To help avoid Late Penalties and Claim Denials please be sure you are submitting your claims in a timely manner.

Dental claims are processed based on Date of Treatment.

Orthodontic claims are processed based on Date of Payment.

Claims should be submitted within 60 days from the date of treatment. If claims are received after 60 days from the date of treatment they are subject to a 20% penalty. If there is primary insurance involved you have 90 days from the date of treatment to get your claims in before receiving a late penalty. Orthodontic claims will not receive late penalties, but they must be received within the appropriate plan year.

Contact DCUE Dental for special circumstances such as primary insurance delaying your claim submission.

How you get Reimbursed

A reimbursement check is mailed to the Member after their claim is processed. 

You should receive a check, to the address we have on file, within two weeks or less. Claims are processed 2-3 times a week so that the turnaround is quick. 

The check is the upper 1/3 of the sheet, the lower 2/3 of the sheet is your Explanation of Benefits (EOB). The EOB gives you your remaining Annual Benefit and remaining Lifetime Orthodontic Benefit. 

Your EOB should be retained for tax purposes and/or Flex Spending Accounts.

If you do not receive your reimbursement check within two weeks of submitting your claim please contact DCUE Dental.

We work hard to process your claims in a timely manner so please help us by cashing your checks as soon as possible.

Forfeiture of Reimbursement Checks

A reimbursement check will be considered forfeited if it meets the three criteria:

-check has been outstanding for at least six (6) months

-member has not responded to notifications of an outstanding check

-original amount of the check is under $250.01

If the original check is issued for $250.01 or more then the un-cashed check will follow state guidelines for Unclaimed Property.

Additional fees may apply to claiming your property.

 Retiring?

What to expect from DCUE Dental when you retire

When DCUE Dental receives notice of your retirement from the the District Office you will be sent a packet of DCUE Dental Continuation of Coverage information.

You can also view information about COBRA/Continuation of Coverage here: https://www.dcue.org/dcue/areas/dental/downloads/COBRA_Information.pdf

Continuation of Coverage or COBRA benefits will be offered to you at your own expense. DCUE Dental is separate from your Health Insurance and will be offered separate from your Health Insurance. 

Our office is typically notified mid-late summer of retirees. Please contact us with questions after you have received your packet of information.

Thank you.

Change of Status?

What to expect from DCUE Dental when there is a change in your status.

If you have a change in status that effects your dental coverage such as a Leave of Abscense, Reduction of Hours, Resignation and/or termination DCUE Dental will be notified by the District.

Once DCUE Dental is notified of your change in status you will be sent an Election Notice and a small packet of information about COBRA/Continuation of Coverage.

You can also view information about COBRA/Continuation of Coverage here: https://www.dcue.org/dcue/areas/dental/downloads/COBRA_Information.pdf

You are able to elect coverage under COBRA for a set amount of months. You are responsible for paying your own premium to conintue coverage.

If there is a delay in receiving your COBRA notice from DCUE Dental please contact our office to check on the status.

 Additional Plan Information

DCUE Dental Annual Enrollment

DCUE Dental has a mandatory annual enrollment for all members actively working in the District.

The online enrollment for each new plan year opens on August 1st and closed June 1st. 

Claim forms can not be processed without a current plan year enrollment. 

The Enrollment deadline is a hard deadline. You will not be able to enroll after June 1st, applicable claim submissions will be denied.

Notices about enrolling and the enrollment period are sent to your District email.

If you are new to the District or are returning to work the District office will notify DCUE Dental of your employment and eligibility. Please contact our office if you did not receive an email notification to enroll after August 1st or shortly after your start date.

Double Spouse Members

 Double Spouse: Both parties are ISD 196 employees AND eligible for coverage in the ISD 196 DCUE collective bargaining unit. (Eligible members are teachers, nurses and counselors with .75 FTE or greater; managed by DCUE as stated in bargaining agreement.)

-Employee #1 will be the member whose online account will be used for Online Enrollment. (Emp #1's account includes both Emp #1 & Emp #2 information for enrolling.)

-Employee #1 is determined by whose birthday falls first in a calendar year.

If Double Spouse status is new for you at anytime during the year please contact our office for instruction and account updates.

Information Changes for Members

If you need to update your address, change your name, add a dependent, etc. you need to do this directly with DCUE Dental.

You can simply edit your enrollment form. Log into the Dental Members tab, click on the Open Enrollment picture, edit button, make your changes, initial and complete form. 

Dental Members page: https://www.dcue.org/dcue/areas/dental/members/log_in.cfm

During the months of June-July you will need email us to make personal changes on your account. Email dental@dcue.org 

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