Questions About Dental Insurance For County Employees:  Healthplex

What is the reimbursement dental care option?

How do I get reimbursed from Healthplex for these services?

What is the comprehensive dental care option?

Will the dentist charge a fee if I select the comprehensive option?

How can I change my dentist?

I continued my dental coverage through COBRA.  Why does Healthplex say that I am not in the system?

Is it possible to switch from the comprehensive coverage to the reimbursement dental plan and vice-versa?

Q:  What is the reimbursement dental care option?
A:  Reimbursement allows you and your eligible dependents to use the services of any dentist you wish.

Q:  How do I get reimbursed from Healthplex for these services?
A:  You must submit a dental claim form to Healthplex.  Dental reimbursement claim forms may be obtained from your department’s Human Resource Officer or can be downloaded by clicking here.

Q:  What is the comprehensive dental care option?
A:  Comprehensive dental care allows you to select a dentist from a panel of dentists.  The dentist provides all necessary care.

Q:  Will the dentist charge a fee if I select the comprehensive option?
A:  For many dental services, such as x-rays, fillings, or prophylaxis, there is no fee.  For other dental services, there may be a pre-determined charge that the enrollee is required to pay.

Q:  How can I change my dentist?
A:  If you have chosen comprehensive coverage, you can change your dentist by calling Healthplex directly at 516-542-2200.

Q:  I continued my dental coverage through COBRA.  Why does Healthplex say that I am not in the system?
A:  If Healthplex records your payment as late, they will say that you are not in the system.  As a practical matter, try to make sure to send your payment to the Comptroller's Office by the 10th day of the month prior to the month for which you would like to receive coverage (i.e. send payment by April 10th for May coverage).

Q:  Is it possible to switch from the comprehensive coverage to the reimbursement dental plan and vice-versa?
A:  Yes, it is possible to change from one plan to another during the Open Enrollment Period (November 15 – December 15).  An Option Change Enrollment Form must be obtained from, completed, and returned to your department’s Human Resource Officer.  The change will be effective as of January 1 of the coming year.