System Benefits Administration : Frequently Asked Questions By Topic

Frequently Asked Questions

ACCIDENTAL DEATH & DISMEMBERMENT
» I’m a foreign national, and my visa requires that I have medical evacuation and repatriation coverage. Does the AD&D coverage meet these requirements?

BENEFIT CHANGES
» When is the Annual Enrollment period?

» What are the different types of Changes in Status and how do they impact my benefits?

» I need to change my beneficiaries. What do I do?

» I will be getting married/divorced soon. What do I need to do to change my name on my records and/or add/drop dependent(s) on my benefits?

DENTAL CARE
» The A&M Dental plan has a $1,500 per person maximum benefit each plan year and a $1,500 per person lifetime maximum on orthodontic care. When I have orthodontic care, do the expenses apply to both maximums or only the orthodontic maximum?

» I am under the care of a periodontist and have my teeth cleaned twice a year at the periodontist’s office and twice a year at my regular dentist’s office. Will the plan cover all of my cleanings?

» How do I find a Delta Network or Premier dentist in my area?

» Are there any pre-existing conditions that won’t be covered immediately under the DeltaCare USA Dental HMO?

» If I enroll in DeltaCare USA, will my benefits be reduced if I go to a dentist who is not in the DeltaCare USA network?

» Why doesn’t DeltaCare USA have an office visit copayment of $20 or $25 like most of the health plans?

» What’s the maximum benefit DeltaCare USA will pay in a year? Is it different for orthodontia?

» How do I find a DeltaCare USA dentist in my area?

» In DeltaCare USA, do I have to get all treatment from a single dentist?

» Last year, my dentist recommended some treatment, and the A&M Dental plan said it would pay only for a less expensive treatment. Does DeltaCare USA have that same rule?

» How is A&M Dental different from DeltaCare USA?

» I am under the care of a periodontist and have my teeth cleaned twice a year at the periodontist’s office and twice a year at my regular dentist’s office. Will the plan cover all of my cleanings?

» How can I find out exactly what my cost will be for my dental care under the A&M Dental plan?

LEAVE
» I have exhausted all my paid sick leave and I am still unable to return to work. What are my options?

» I have been notified that my absence from work is covered under the Family and Medical Leave Act (FMLA); however, I have exhausted all paid leave. What are my options now?

» I am not eligible for FMLA, but want to take a leave of absence due to the birth of my baby. What are my choices?

» How will my leave without pay affect my state service for longevity pay and vacation accrual purposes?

LIFE INSURANCE
» Do I need to provide evidence of insurability to enroll in Optional Life coverage?

» How does the automatic Dependent Basic Life coverage work?

» What is the difference between Basic Life/Basic AD&D, Alternate Basic Life and Optional Life?

» If I increase my Optional Life coverage during Annual Enrollment, when is the increase effective?

» Why set up an Alternate Basic Life plan if anyone can buy Optional Life?

» How does the Living Access benefit work?

» If I sign up for Dependent Life, are all of my eligible dependents automatically covered?

» What is the portability provision in the life insurance program?

» How do I change my beneficiaries?

LONG-TERM CARE
» What if I elect the $100-a-day benefit and my care only costs $80 a day. Do I receive $80 or the full $100?

» If I’m in a nursing home or other facility and have to go to the hospital for awhile, will the benefits being paid for that facility stop?

» Can I pay premiums for my parents and adult children through payroll deduction?

» If I already have Long-Term Care coverage, can I increase my level of coverage without providing evidence of insurability?

» What’s the definition of "adult" children who can enroll in Long-Term Care coverage?

» Do I have to provide evidence of good health to enroll in the Long-Term Care plan?

» What are alternate care facilities and independent providers, which are covered by the plan?

» What kinds of benefits will I receive for services other than skilled nursing facility care and home health care that are covered by the plan?

» If I participate in the Long-Term Care plan for several years then drop the coverage, can I ever get benefits from the plan?

» I’ve participated in the Long-Term Care plan since it was first offered. I think the nonforfeiture benefit is great, but would my benefit be based on the total premiums I’ve paid since I first enrolled or only the premiums I paid after switching to John Hancock?

» If I buy Long-Term Care for myself and then one of my parents needs care, can I use my benefits to pay the bills if I’m the one responsible for paying for my parent’s care?

» Won’t my health plan cover most of the same services as the Long-Term Care plan?

» Do I have to enroll in Long-Term Care in order for my spouse to enroll?

» What is the Automatic Benefit Increase op