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

As an eligible employee, you can choose to enroll in a dental plan by completing the SHBP Dental Application. 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:

In-Network 

    • Indemnity (fee for service) plan
    • Yearly deductible - $50 / Individual , $100 / Family (Waived for Preventive)
    • 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
    • Orthodontic services for children under age 19 – copayment of $1,000 required or 50 percent of reasonable and customary charges, whichever is less
    • $3,000 maximum reimbursement limit per person per calendar year

Out of Network

  • Indemnity (fee for service) plan
  • Yearly deductible - $75 / Individual, $150 / Family (Waived for Preventive)
  • 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
  • Orthodontic services for children under age 19 – copayment of 40 percent to $750 lifetime (maximum of $1,000 combined in and out of-network) (not subject to 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
  • Orthodontic services for children and adults covered - maximum 24 months