Frequently Asked Questions

• Are Delta dentists dropping from the plan in Los Alamos?
  Click here for news about Delta Dental changes that affect Los Alamos.
• Are my family members eligible for dental coverage?
  Your legal spouse, adult dependent relative or same-sex domestic partner as well as your child(ren), grandchild(ren), adult disabled child(ren), and legal ward(s) may be eligible for dental insurance coverage if you are eligible for benefits and if they meet certain eligibility requirements. See Group Insurance Eligibility Factsheet for eligibility requirements. In addition to yourself, you may enroll only one type of adult family member (legal spouse, or adult dependent relative, or same-sex domestic partner) in your UC-sponsored insurance plans. For example, if you enroll your adult dependent relative in your dental plan, you may not enroll your spouse in any plan (medical, dental, or vision). UC and/or the insurance carriers may request that you provide documentation (marriage or birth certificates, adoption papers, tax records, etc.) to verify eligibility.
• Can I have my long-term health care premiums automatically deducted from my paycheck?
  At this time, you must send your premiums directly to CalPers at Long-Term Care Group CalPERS Long-Term Care Program P.O. Box 5708 Hopkins, MN 55343-5708. Benefits, Payroll, and CalPers are currently working on setting up this option and will notify you if/when payroll deduction becomes an option.
• Do I have any long-term care coverage options?
  Applicants may choose from a broad array of benefits options in each of the three CalPERS long-term care plans: Comprehensive, Nursing Home/Assisted Living Facility Only, or Partnership. Each plan offers two options, Option 100 and Option 130, which have different total coverage amounts.
• How and when can I enroll in the dental insurance program?
  If you are newly hired, you have a period of initial eligibility (PIE) during which you may enroll yourself and your eligible family members. Your PIE starts on the first day of eligibility (for example, the day you begin work in a position that makes you eligible for medical coverage). The PIE ends 31 days later or on the last working day of that 31-day period, whichever comes first. To enroll: You need to complete the LANL Insurance enrollment form and return it to the Benefits Office prior to the end of your 31-day PIE. If you miss your PIE, you may enroll in dental coverage during Open Enrollment, which is usually held in November. If you become eligible for UC-sponsored benefits because of a change in employment status (i.e. change from casual status or limited benefits to full benefits or change from contractor to UC) you will have a 31-day period of initial eligibility in which to enroll. When you experience a change which you believe may change your benefit status you will need to contact the Benefits Office at 7-1806 or via e-mail at benefits@lanl.gov to see exactly when your PIE begins.
• How and when can I enroll my family members in the dental insurance plan?
  If you are enrolled in a dental plan, your newly eligible family members may be added to your current plan. You must request enrollment within 31 days from the date your family member is first eligible (i.e. date of birth of a child, marriage date). To complete the enrollment form contact the Benefits Office at 7-1806 or via e-mail at benefits@lanl.gov. If you are not enrolled in a dental plan, you and your eligible family members may enroll during Open Enrollment, which is usually held in November for coverage effective January 1st of the following year.
• How are my long-term care premiums determined?
  Premiums are age-related, so the younger you are when you apply, the less a plan costs. CalPERS provides a premium calculator to determine monthly rates. After reading this information, enter your age and your monthly premiums will be calculated for each of the three plans. The calculations will also tell you what your monthly premiums will be if you choose one of the Inflation Protection options.
• How can I find a dentist?
  With Delta Dental you have the choice of using an in-network or out-of-network dentist. You can use the provider directory on Delta's web site to locate a Delta Dental in-network provider.
• How do I contact Delta Dental?
  Although our dental insurance claims payment, contracting and customer service is now provided by Delta Dental of California, the New Mexico provider directories are still found on the Delta Dental of New Mexico web site. For more information contact Delta Dental of California at 1-800-777-5854. The New Mexico provider directory can be found at deltadentalnm.com.
• How much does dental insurance cost?
  Currently, UC pays the entire cost of coverage for all employees. This arrangement is subject to the State of California appropriation, which may change or be discontinued in future years. All plan members pay a certain percentage or copayment for some services. See the Dental Plan Summary for details.
• What about the affects of inflation on long-term health care coverage?
  When choosing long-term care coverage, it is important to consider what inflation can do to the future cost of long-term care services and the value of the coverage you buy today. That is why the CalPERS Long-Term Care Program gives you the option of purchasing Inflation Protection. You are given two choices to protect the value of your coverage against inflation: the Built-In Inflation Protection [http://www.calpers.ca.gov/longtermcare/program/built-in.htm] or the Periodic Benefit Increase Option [http://www.calpers.ca.gov/longtermcare/program/periodic.htm].
• What do I do if I have lost my non-UC sponsored dental insurance coverage?
  If you and/ or an eligible family member involuntarily lose other dental insurance coverage, you may enroll in the UC dental plan. A new 31-day PIE starts the day you lose coverage. You must furnish proof that other employer group coverage was lost. To enroll contact the Benefits Office at 7-1806 or via e-mail at benefits@lanl.gov.
• What does my dental insurance cover?
  For more information on what the plan covers, see the Dental Plan Summary.
• What does the Long-term care program offer that my other insurance doesn't?
  Medicare, Medi-Gap, health plans, and disability insurance typically provide little or no long-term care coverage. They were designed to cover hospital and doctor care, not extended or personal care. If you want long-term care protection, you must purchase it separately.
• What if I see the dentist and they tell me I am not enrolled?
  If you are a new employee, there is a chance that Delta Dental may not yet have you in their system. If your dentist informs you that you are not eligible, you will need to contact the Benefits Office at 7-1806 or via e-mail at benefits@lanl.gov to verify eligibility.
• What is long-term care?
  Long-term care (LTC) is the extended care you may need when, because of a chronic illness, injury or frailty of old age, help is required with basic activities like bathing, dressing, or eating. It is the extended care you typically receive at home from a nurse, a home health aide or a family member, or it can be provided in a nursing home, assisted living facility, or adult day care center.
• What is the co-payment schedule if I use a participating eye doctor?
  There is a $10 co-payment for the examination payable to the doctor at the time of the examination. If lenses and/or frames are also provided, there will be an additional $25 co-payment.
• When and how can I enroll in long-term care coverage?
  The application period is held annually beginning in April. During the application period, you can request an application kit from the Benefits Office. The kit has information about all of the plans, two application forms, and a postage-paid, self-addressed envelope. You can also request an application kit by calling 1-800-2661050 or visit the CalPERS Website.
• When does dental coverage begin?
  Coverage under UC-sponsored dental plans generally starts on your first work day, provided you enroll during your period of initial eligibility (PIE). You must also enroll eligible family members before the PIE ends. If you enroll in a dental plan during Open Enrollment, coverage begins January 1.
• Who do I call with questions regarding the Long-term Care Program?
  Your questions about the Long-term Care Program might be answered by Ask CalPERS on the CalPers Website. If your questions still have not been answered after reviewing this section, please contact CalPers at 1-800-908-9119, Monday thru Friday, 7:00 a.m. thru 7:00 p.m. Pacific time.
• Who is the long-term care provider and who is eligible to enroll?
  Coverage under the CalPERS Long-Term Care Program is available to all current and retired employees, their spouses, parents (includes step-parents), parents-in-law, and siblings (18 years and older).
• Why should I be interested in long-term care?
  Long-term care coverage gives you financial protection and peace of mind. It preserves and protects your financial resources while giving you the knowledge that you will have access to the best long-term health care should you need it. You might think you are too young to need this type of coverage, however, an accident or illness can happen at any time.
• Will I have an insurance card to present to my dentist?
  No. When you visit a Delta Dental provider you merely need to let them know that you are enrolled in Delta Dental NM and they will be able to identify your eligibility. Your member number is the social security number of the LANL employee who is enrolled. All eligible family member eligibility will be under this same number.