Eligibility to Enroll in the State Health Benefits Program
Eligibility for Dependents
- Legal spouse
- Same-sex domestic partner or civil union partner
- Eligible children under age 26 (including stepchildren, foster children, adopted children or children an employee is legally required to support)
When Coverage Begins
- Academic year 10-month employees with September 1 hire date = September 1 effective date
- All other employees, effective after 2 months of continuous employment, i.e., August 15 hire date = October 15 effective date
Rutgers offers two types of dental insurance plans:
Please be sure to review the plan rules including exclusions and limitations before selecting a plan. You must remain in the dental plan you select for at least 12 months before you can transfer to another dental plan or cancel coverage.
The Dental Expense Plan (PPO):
In-Network
- Indemnity (fee for service) plan
- Deductible - $50 / Individual , $100 / Family (Waived for Preventive) per calendar year
- Exams and cleanings covered at 100 percent (no deductible)
- Basic restorative services covered at 80 percent after deductible
- Major restorative services (inlays, onlays, crowns) covered at 65 percent after deductible
- Periodontic and prosthodontic procedures covered at 50 percent after deductible
- $3,000 maximum reimbursement limit per person per calendar year
Out of Network
- Indemnity (fee for service) plan
- Deductible - $75 / Individual, $150 / Family (Waived for Preventive) per calendar year
- Exams and cleanings covered at 90 percent (no deductible)
- Basic Restorative services covered at 70 percent after deductible
- Major Restorative covered at 55 percent after deductible
- Periodontics & Prosthodontic procedures covered at 40 percent after deductible
- $2,000 (Maximum of $3,000 combined in and out-of-network) per person per calendar year
Dental Plan Organizations (DPOs)
- Similar to medical HMO program
- Several DPOs to choose from
- Must use a DPO network dentist
- Co-payments required
- Routine exams, cleanings and preventive care covered 100%
- Co-payments required for other dental services