Dental Insurance

You can enroll during IBM's Annual Benefits Enrollment period or if you experience a Qualified Status Change. New hires can enroll within 60 days from their date of hire.

A participating dentist is a general dentist or specialist who has agreed to accept negotiated fees as payment in full for services provided to plan members. Negotiated fees typically range from 30–45% below the average fees charged in a dentist’s community for the same or substantially similar services.²

There are thousands of general dentists and specialists to choose from nationwide — so you are sure to find one who meets your needs. You can receive a list of these participating dentists online at metlife.com by following these instructions or call 1-800-872-6963 to have a list mailed to you.

You do not need an ID card to receive dental services. However, if you enroll in a dental option administered by MetLife, you will receive an ID card, which will remain good for as long as you are enrolled in any dental option administered by MetLife. New cards will not be sent each year. If your card is lost or damaged, call MetLife’s Dental Service Center to request a replacement card or log onto www.metlife.com/mybenefits to print one.

Dentists may submit your claims for you which means you have little or no paperwork. You can track your claims online and even receive e-mail alerts when a claim has been processed. If you need a claim form, visit metlife.com or request one by calling 1-800-872-6963.

Yes. You can ask for a pre-treatment estimate. Your general dentist or specialist usually sends MetLife a plan for your care and requests an estimate of benefits. The estimate helps you prepare for the cost of dental services. We recommend that you request a pre-treatment estimate for services in excess of $300. Simply have your dentist submit a request online at metdental.com, or call 1-877-MET-DDS9. You and your dentist will receive a benefit estimate for most procedures while you are still in the office. Actual payments may vary depending upon plan maximums, deductibles, frequency limits and other conditions at time of payment.

Yes. Through international dental travel assistance services³, you can obtain a referral to a local dentist by calling +1-312-356-5970 (collect) when outside the U.S. to receive immediate care until you can see your dentist. Coverage will be considered under your out-of-network benefits.⁴ Please remember to hold on to all receipts to submit a dental claim.

Coordination of benefits provisions in dental benefits plans are a set of rules that are followed when a patient is covered by more than one dental benefits plan. These rules determine the order in which the plans will pay benefits. If the MetLife dental benefit plan is primary, MetLife will pay the full amount of benefits that would normally be available under the plan. If the MetLife dental benefit plan is secondary, most coordination of benefits provisions require MetLife to determine benefits after benefits have been determined under the primary plan. The amount of benefits payable by MetLife may be reduced due to the benefits paid under the primary plan, but the two plans may work together to provide up to 100% coverage. For more information, contact MetLife’s Dental Service Center.

This is the total amount the plan will pay in the plan year. Once this amount is reached, no further benefits will be paid. The Annual Maximum for IBM Dental Basic option is $500 per individual. For IBM Dental Plus option, the Annual Maximum is $2,000 per individual.

For active employees, only the IBM Dental Plus option covers orthodontia treatment. For retirees, the IBM Dental Plus, Option A, and MetLife PDP options cover orthodontia treatment. The Orthodontia Lifetime Maximum is the total amount the plan will pay for orthodontic services for each covered person (subject to any plan age limitations). Once this amount is reached, no further benefits will be paid. This does not affect your Annual Maximum Benefit for Preventive, Basic Restorative, and Major Restorative coverages.

The Oral Fitness Library is a resource, provided by MetLife, available to all IBMers. It provides easily understood, dependable information regarding oral health and dental care such as:

• Articles and videos on helpful topics like dental issues and treatments, the link between oral health and overall health, and more
• Tools that support decision-making, like Health Risk Assessments (HRA) and treatment plan checklists
• Benefits education to compare different dental plan types and understand how they work

The information and tools available are reviewed by experts to ensure they include the most current and researched guidance on any topic. Our MetLife Dental Advisory Council reviews and selects resources from trusted, industry experts — like the American Dental Association. The council is made up of respected academic and practicing dentists, so you can count on the details being right.

All active regular full-time, regular part-time and retiree supplemental employees of International Business Machines Corporation, or those subsidiaries of IBM authorized to participate in the plans, regularly assigned in the United States of America, its territories and possessions and the Commonwealth of Puerto Rico, and their dependents (spouse/domestic partner and children), are eligible for the Dental Insurance options for Active Employees. This includes long-term supplemental employees.

Spouse and domestic partner are defined as follows:

• Your spouse (same or opposite sex), if the marriage met the laws of the jurisdiction in which it was entered into.
• Your domestic partner (same or opposite sex), if the marriage met the laws of the jurisdiction in which it was entered into.
• Your common-law spouse may be eligible in certain circumstances. To meet the eligibility criteria to add a common-law spouse to your health coverage, you must:
  • Reside in a state that recognizes common-law marriage
  • Openly represent yourselves as husband and wife to government and tax authorities as well as to your relatives, friends, neighbors, coworkers and acquaintances with whom you associate. It is expected that you file your income taxes as “married”
  • Change your status to “married” at IBM and ensure that your IRS form W-4 reflects “married”
  • Not be legally married to another person

A child can be covered only up until age 26. A child includes your biological children, stepchildren, adopted children, and any child who resides with and is fully supported by you. Children who are disabled and were enrolled in dental coverage under the IBM Medical and Dental Benefits Plan for Regular Full-time and Regular Part-time Employees prior to attaining age 26 are eligible to retain coverage after they attain age 26. Disabled means incapable of self-sustaining employment because of mental or physical handicap.

Insurance for a disabled child may be continued past the age limit if the child is incapable of self-sustaining employment because of a mental or physical handicap, as defined by applicable law, and can be continued as long as the child:

• Remains incapable of self-sustaining employment because of a mental or physical handicap; and
• Continues to qualify as a Child, except for the age limit.
   

The Application for Coverage of Disabled Dependent Child Under IBM Health Benefit Plans form must be completed and sent to the IBM Benefits Center – Provided by Fidelity 60 days before the date the child attains age 26. It is your responsibility to notify the IBM Benefits Center – Provided by Fidelity of any changes to the child’s eligibility for coverage.

The IBM Dental basic option provides coverage for preventive, diagnostic and basic restorative care, up to $500 per covered person per year.

The chart below shows what you pay for covered services under the IBM Dental Basic option.
Note: Frequency and treatment limits may apply, and the most common care procedures are listed in each category, other procedures may be covered. Also, some procedures have varying levels of treatment. Contact MetLife for more details.

The IBM Dental Plus option offers an enhanced benefit, covering preventive, diagnostic, basic restorative and major restorative services, up to $2,000 per covered person per year, as well as orthodontia care, limited to a lifetime maximum of $2,500 per covered person.

The chart below shows what you pay for covered services under the IBM Dental Plus option.
Note: Frequency and treatment limits may apply and the most common care procedures are listed in each category, other procedures may be covered. Also, some procedures have varying levels of treatment. Contact MetLife for more details.

Yes. You are always free to select the dentist of your choice. However, if you choose a non-participating dentist, your out-of-pocket costs may be higher.

Yes. If your current dentist does not participate in the network and you would like to encourage him or her to apply, ask your dentist to visit metdental.com, or call 1-866-PDP-NTWK for an application.⁵ The website and phone number are for use by dental professionals only.

Think about this: Having a good dental plan in place can help you save money every year.⁶ You also get protection against costly emergency dental treatments that may run into the hundreds or even thousands of dollars. In-network dentists have agreed to accept negotiated fees as payment in full for covered services, subject to any deductibles, copayments, cost sharing and benefits maximums. Negotiated fees typically range from 30–45% below the average fees charged in a dentist’s community for similar services.² Non-participating dentists have not agreed to accept negotiated fees.

In particular, the cost of specialty care like implants, root canals and crowns can really add up. That’s why it’s good to know the network is there to help you manage your out-of-pocket costs. You can view potential savings on in-network vs. out-of-network fees by using the Dental Procedure Tool.

Premiums will be conveniently paid through payroll deduction for those on active payroll. So you don’t have to worry about writing a check or missing a payment. If you are not on active payroll or are a Retiree Supplemental employee, you will be direct billed for your Dental premiums.

Retirees who are not Medicare-eligible, their eligible dependents, non-Medicare-eligible dependents of Medicare-eligible retirees or participants in the Personal Benefits Program section of the Retiree Summary Plan Description (SPD) are eligible to enroll in dental coverage under the Plan.

If you and your eligible family members are living outside of the U.S. and Puerto Rico, you will be eligible for dental benefits reimbursement for eligible services but at the out-of-network level only since there are no network providers outside of the U.S. and Puerto Rico.

Note that once you (and/or your eligible dependent(s)) reach age 65 or become eligible for Medicare, you will no longer be eligible for dental coverage under the Plan.

If You Retired from IBM On or Before December 31, 2004
You may only enroll those dependents in your IBM medical, dental and/or vision coverage who met eligibility guidelines as of December 31, 2004. Any new dependents — such as those you gain through marriage/domestic partnership, birth or adoption — after December 31, 2004, are not eligible to enroll in your IBM medical, dental and/or vision coverage.

If you have a dependent who met eligibility requirements as of December 31, 2004, but who is not currently enrolled in an IBM medical, dental and/or vision option, that individual may enroll for coverage under the Plan as long as he or she continues to meet dependent eligibility guidelines.

Spouse and domestic partner are defined as follows:

• Your spouse (same or opposite sex), if the marriage met the laws of the jurisdiction in which it was entered into.
• Your domestic partner (same or opposite sex), if the marriage met the laws of the jurisdiction in which it was entered into.
• Your common-law spouse may be eligible in certain circumstances. To meet the eligibility criteria to add a common-law spouse to your health coverage, you must:
  • Reside in a state that recognizes common-law marriage
  • Openly represent yourselves as husband and wife to government and tax authorities as well as to your relatives, friends, neighbors, coworkers and acquaintances with whom you associate. It is expected that you file your income taxes as “married”
  • Change your status to “married” at IBM and ensure that your IRS form W-4 reflects “married”
  • Not be legally married to another person

A child can be covered only up until age 19, unless they are a full-time student and then can be covered until age 23. A child includes your biological children, stepchildren, adopted children, and any child who resides with and is fully supported by you. Children who are disabled and were enrolled in dental coverage under the IBM Medical and Dental Benefits Plan for Regular Full-time and Regular Part-time Employees prior to attaining age 19 are eligible to retain coverage after they attain age 19. Disabled means incapable of self-sustaining employment because of mental or physical handicap.

Insurance for a disabled child may be continued past the age limit if the child is incapable of self-sustaining employment because of a mental or physical handicap, as defined by applicable law, and can be continued as long as the child:

• Remains incapable of self-sustaining employment because of a mental or physical handicap; and
• Continues to qualify as a Child, except for the age limit.
   

The Application for Coverage of Disabled Dependent Child Under IBM Health Benefit Plans form must be completed and sent to the IBM Benefits Center – Provided by Fidelity 60 days before the date the child attains age 19. It is your responsibility to notify the IBM Benefits Center – Provided by Fidelity of any changes to the child’s eligibility for coverage.

The Dental Option A plan an enhanced benefit, covering preventive, diagnostic, basic restorative, major restorative, and orthodontia care, limited to an overall lifetime maximum of $9,000 per covered person. Orthodontic care is limited to a lifetime maximum of $1,500 per covered person and also applies to the overall lifetime maximum.

The chart below shows what you pay for covered services under the Dental Option A plan.
Note: Frequency and treatment limits may apply and only the most common care procedures are listed in each category, other procedures may be covered. Also, some procedures have varying levels of treatment. Contact MetLife for more details.

The Dental Option B plan provides coverage for preventive, diagnostic and basic restorative care, up to an overall lifetime maximum of $9,000.

The chart below shows what you pay for covered services under the Dental Option B plan.
Note: Frequency and treatment limits may apply and only the most common care procedures are listed in each category, other procedures may be covered. Also, some procedures have varying levels of treatment. Contact MetLife for more details.

The MetLife Preferred Dental Program (PDP) option offers an enhanced benefit, covering preventive, diagnostic, basic restorative, major restorative with no annual or overall lifetimes maximum, and orthodontia care, limited to a lifetime maximum of $1,500 per covered person.

The chart below shows what you pay for covered services under the MetLife Preferred Dental Program (PDP) option.
Note: Frequency and treatment limits may apply and only the most common care procedures are listed in each category, other procedures may be covered. Also, some procedures have varying levels of treatment. Contact MetLife for more details.

Yes. You are always free to select the dentist of your choice. However, if you choose a non-participating dentist, your out-of-pocket costs may be higher and, if you’re enrolled in the MetLife PDP option, not all services may be covered.

Yes. If your current dentist does not participate in the network and you would like to encourage him or her to apply, ask your dentist to visit metdental.com, or call 1-866-PDP-NTWK for an application.³ The website and phone number are for use by dental professionals only.

Retirees who are not Medicare-eligible, their eligible dependents, non-Medicare-eligible dependents of Medicare-eligible retirees or participants in the Personal Benefits Program section of the Retiree Summary Plan Description (SPD) are eligible to enroll in dental coverage under the Plan.

If you and your eligible family members are living outside of the U.S. and Puerto Rico, you will be eligible for dental benefits reimbursement for eligible services but at the out-of-network level only since there are no network providers outside of the U.S. and Puerto Rico.

Note that once you (and/or your eligible dependent(s)) reach age 65 or become eligible for Medicare, you will no longer be eligible for dental coverage under the Plan.

If You Retired from IBM On or Before December 31, 2004
You may only enroll those dependents in your IBM medical, dental and/or vision coverage who met eligibility guidelines as of December 31, 2004. Any new dependents — such as those you gain through marriage/domestic partnership, birth or adoption — after December 31, 2004, are not eligible to enroll in your IBM medical, dental and/or vision coverage.

If you have a dependent who met eligibility requirements as of December 31, 2004, but who is not currently enrolled in an IBM medical, dental and/or vision option, that individual may enroll for coverage under the Plan as long as he or she continues to meet dependent eligibility guidelines.

If You Retired from IBM On or After January 1, 2005
You may enroll only those dependents in your IBM medical, dental and/or vision coverage who meet dependent eligibility guidelines as of your retirement date. You may not enroll dependents you gain after your retirement date — for example, a new spouse/domestic partner or a dependent child acquired by birth, adoption or marriage.

Spouse and domestic partner are defined as follows:

• Your spouse (same or opposite sex), if the marriage met the laws of the jurisdiction in which it was entered into. 
• Your domestic partner (same or opposite sex), if the marriage met the laws of the jurisdiction in which it was entered into.
• Your common-law spouse may be eligible in certain circumstances. To meet the eligibility criteria to add a common-law spouse to your health coverage, you must:
  • Reside in a state that recognizes common-law marriage
  • Openly represent yourselves as husband and wife to government and tax authorities as well as to your relatives, friends, neighbors, coworkers and acquaintances with whom you associate. It is expected that you file your income taxes as “married”
  • Change your status to “married” at IBM and ensure that your IRS form W-4 reflects “married”
  • Not be legally married to another person

A child can be covered only up until age 19, unless they are a full-time student and then can be covered until age 23. A child includes your biological children, stepchildren, adopted children, and any child who resides with and is fully supported by you. Children who are disabled and were enrolled in dental coverage under the IBM Medical and Dental Benefits Plan for Regular Full-time and Regular Part-time Employees prior to attaining age 19 are eligible to retain coverage after they attain age 19. Disabled means incapable of self-sustaining employment because of mental or physical handicap.

Insurance for a disabled child may be continued past the age limit if the child is incapable of self-sustaining employment because of a mental or physical handicap, as defined by applicable law, and can be continued as long as the child:

• Remains incapable of self-sustaining employment because of a mental or physical handicap; and
• Continues to qualify as a Child, except for the age limit.

The Application for Coverage of Disabled Dependent Child Under IBM Health Benefit Plans form must be completed and sent to the IBM Benefits Center – Provided by Fidelity 60 days before the date the child attains age 19. It is your responsibility to notify the IBM Benefits Center – Provided by Fidelity of any changes to the child’s eligibility for coverage.

The IBM Dental Basic option provides coverage for preventive, diagnostic and basic restorative care, up to $500 per covered person per year.

The chart below shows what you pay for covered services under the IBM Dental Basic option.
Note: Frequency and treatment limits may apply and only the most common care procedures are listed in each category, other procedures may be covered. Also, some procedures have varying levels of treatment. Contact MetLife for more details.

The IBM Dental Plus option offers an enhanced benefit, covering preventive, diagnostic, basic restorative and major restorative services up to $2,000 per covered person per year, and orthodontia care, limited to a lifetime maximum of $2,500 per covered person.

The chart below shows what you pay for covered services under the IBM Dental Plus option.
Note: Frequency and treatment limits may apply and only the most common care procedures are listed in each category, other procedures may be covered. Also, some procedures have varying levels of treatment. Contact MetLife for more details.

Yes. You are always free to select the dentist of your choice. However, if you choose a non-participating dentist, your out-of-pocket costs may be higher.

Yes. If your current dentist does not participate in the network and you would like to encourage him or her to apply, ask your dentist to visit metdental.com, or call 1-866-PDP-NTWK for an application.³ The website and phone number are for use by dental professionals only.

Think about this: Having a good dental plan in place can help you save money every year.⁵ You also get protection against costly emergency dental treatments that may run into the hundreds or even thousands of dollars. In-network dentists have agreed to accept negotiated fees as payment in full for covered services. Negotiated fees typically range from 30–45% below the average fees charged in a dentist’s community for similar services.² Non-participating dentists have not agreed to accept negotiated fees.

In particular, the cost of specialty care like implants, root canals and crowns can really add up. That’s why it’s good to know the network is there to help you manage your out-of-pocket costs. You can view potential savings on in-network vs. out-of-network fees by using the Dental Procedure Tool.