For Local-127 represented employees: please see communication from your association concerning your dental options.
For MEA represented employees: this plan is available as a flexible benefit option, that must be enrolled in through SAP.
For non-MEA represented employees: this plan is only available through payroll deduction. For flex options go to the City’s website, which will be available when the City's enrollment period begins.
Dental work is expensive. That’s why quality dental insurance is extremely important. We’ve partnered with MetLife to make sure SDPEBA members are covered when it comes to everything from routine cleanings and cavities to root canals and fillings.
To explain the HMO plan, it’s easier to compare it to the PPO plan. The HMO plan offers copays that are all outlined on your summary of benefits, whereas the PPO plan separates different procedures into type A, B, C, or D. The HMO plan is very explicit with the costs for each procedure and has a comprehensive list in the plan’s brochure. The PPO plan on the other hand has categorized each procedure and you pay a percentage based on which category your treatment falls into. The HMO plan restricts you to go to one specific in-network dentist, whereas the PPO plan allows you to go to any covered dentist no matter what.
The HMO plan is designed specifically to keep prices down. It’s very rigid in what’s covered, and you might run into circumstances where you won’t have coverage for exactly what you want (e.g. a specific type of material for a filling or brand of orthodontics), but that’s all in order to keep premiums and copays as low as possible.
It’s also important to know that, with the HMO plan, you might have multiple charges for one trip. This happens because there are different copays listed for each procedure that you undergo at the dentist. We’re specifying this because, under the HMO plan, every office visit costs $5 to begin with and several procedures require multiple visits. Some procedures, like restorations, also involve a wide array of treatment steps, each having their own copay and every trip will have that $5 charge added on top.
This isn’t to say the HMO plan is not right for anyone or that it is unreasonable. We simply recommend you look closely at the individual listings and suggest that you talk with your dentist about the services you’re receiving to make sure you know how much you’ll be paying. You should always request a pretreatment estimate before getting procedures at the dentist. If you need help understanding your pretreatment estimate, email Support@SDPEBA.org and we can talk you through it.
In order to see what the HMO plan covers, we highly recommend you check out the HMO Summary of Benefits linked on the sidebar. There is a lot on here, but don’t get overwhelmed. The table on this page features the code, the treatment, and how much you’ll pay. We recommend you use your computer’s “Ctrl-F” function, which allows you to search a document for keywords. If you’re on your phone, there should be a small magnifying glass symbol at the top of your screen. There you can type any procedure in and see how much it’ll cost.
Is the HMO plan right for me?
If you’re just going to the dentist twice a year for routine cleanings and exams, this is a great plan since it is so affordable. If you are regularly in need of dental care or need orthodontics, we recommend you look closely at this plan and how much these procedures might cost you in a given year. If you’re still on the fence, we recommend you check out the PPO plan and everything it covers.
How much does this plan cost?
To view up to date rates, please check the rate sheet on the sidebar for a detailed breakdown of the plan's cost.
How do I enroll?
To enroll in MetLife Dental, simply click "Enroll Now" on the sidebar or call 888-315-8027 during Open Enrollment. If you have any questions about enrolling, feel free to call that number or email support@SDPEBA.org. If you already have the HMO plan, you don’t need to reenroll, only contact us to add, change, or remove your existing plans. Note: MEA employees will need to enroll in MetLife Dental via SAP during the City's enrollment period.
How do I use my plan?
Once the plan begins on January 1st and you’ve been assigned to an in-network provider, you are ready to go! You just need to go to set up your appointment with your assigned dentist. Steps from there will vary dentist to dentist but will probably involve you filling out a form online or calling in.
About Us
The San Diego Public Employee Benefit Association is a partnership of unions and associations designed to help reduce costs, improve benefits, and enhance support for San Diego’s public employees. We’re here to answer your questions and help make sure you get the most out of your benefits while also advocating for you directly to the provider to make sure you get the best experience possible.