Association Member Benefits Advisors
Good News! The Texas Public Employees Association (TPEA) has endorsed a new package of additional benefits, including dental and eye care, exclusively for TPEA members and their families. These plans have been tailored especially for you and your family, and offer an excellent benefits package while being competitively priced.
Plan Comparisons
Dental: The new plan retains all the flexibility of the plan offered by the state, but with superior benefits at comparable costs.
Click to compare:
- Rates
- Features
- Coverage
| Rates | TPEA (effective 8/1) | State PPO |
| Member | 26.02 | 22.46 |
| Member + Spouse | 54.70 | 44.92 |
| Member + Child | 54.70 | 53.90 |
| Family | 95.98 | 76.36 |
| Features | TPEA (effective 8/1) | State PPO | Summary |
| Visit Any Dentist | Yes, out of network dentists covered at a high (80th percentile) rate | No, out of network reimbursed at in-network rate which is a significant hit to paid benefits | TPEA plan allows you to keep the dentist you are comfortable with |
| Annual Maximum | $1,250 | $1,500 | State plan starts out higher, but with rewards/rollover, TPEA catches up |
| Rollover / Rewards | Yes (500/250/1000) | No | TPEA allows you to rollover some of your unused benefit |
| Maximum Benefit | $2,250 | $1,500 | TPEA has a higher potential maximum benefit |
| Two Year Rates | Yes | No | TPEA makes two year rate and benefit guarantees |
| Enrollment Flexibility | Enroll/Drop at anytime (request 12 months) | Locked in for one year | TPEA has a 'no hassle' enroll and drop policy |
| Deductible | $75 (waive on preventive svcs) | $50 in network; $150 out of network | |
| Orthodontial Covered | 50%, $1,000 lifetime, child and adult | 50%, $1500 lifetime, child only | TPEA covers both adult and child ortho |
| Coverage | TPEA (Y1 / Y2+) | State PPO (in / out) | Summary |
| Cleanings | 70% / 100% | 100% / 90% | State has Y1 advantage, TPEA Y2+ |
| Routine Exams | 70% / 100% | 100% / 90% | State has Y1 advantage, TPEA Y2+ |
| X-rays (bitewing, 4 film) | 70% / 100% | 100% / 90% | State has Y1 advantage, TPEA Y2+ |
| X-rays (panoramic) | 70% / 100% | 100% / 90% | State has Y1 advantage, TPEA Y2+ |
| Fillings (one surface) | 60% / 80% | 90% / 70% | |
| Anesthesia | 60% / 80% | 50% / 40% | TPEA has advantage |
| Denture Repair | 60% / 80% | 50% / 40% | TPEA has advantage |
| Simple Extractions | 60% / 80% | 50% / 40% | TPEA has advantage |
| Complex Extractions | 25% / 50% | 50% / 40% | State has Y1 advantage, TPEA Y2+ |
| Porcelain Crowns | 25% / 50% | 50% / 40% | State has Y1 advantage, TPEA Y2+ |
| Crown Repair | 25% / 50% | 50% / 40% | State has Y1 advantage, TPEA Y2+ |
| Dentures | 25% / 50% | 50% / 40% | State has Y1 advantage, TPEA Y2+ |
| Root Canal | 25% / 50% | 50% / 40% | State has Y1 advantage, TPEA Y2+ |
| Peridontal Scaling | 25% / 50% | 50% / 40% | State has Y1 advantage, TPEA Y2+ |
| Periodontal Maintenace | 25% / 50% | 50% / 40% | State has Y1 advantage, TPEA Y2+ |
| Periodontal Surgery | 25% / 50% | 50% / 40% | State has Y1 advantage, TPEA Y2+ |
Vision: An enhanced vision care program, Vision Service Plan (VSP), is another exciting new program offered exclusively to TPEA members. Its coverage goes beyond the simple eye exam provided for state employees under the state health plan. The Member Only monthly premium is $11.75, Member + One is $21.30, and Family is $27.15.
| State Plan | TPEA* | |
|---|---|---|
| Exam | Fully Covered |
Fully Covered, copay waived! |
| Lenses† | Not Covered |
Fully Covered |
| Frames† or Contacts | Not Covered |
$120 Allowance/20% out of pocket costs |
*Costs with VSP network discount. |
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These are only some of the benefits available to TPEA members who sign up!
For more information on AMBA benefits, please visit their website.
Dental Insurance Plan
Download information sheet (requires Adobe Reader)The TPEA sponsored group dental insurance plan, underwritten by Ameritas Life Insurance Corp., provides several benefits that are not available through the state plan.
The TPEA Ameritas Plan Offers:
- The freedom to use any dentist! (Ameritas Network dentists are discounted an additional 20% - 30%)!
- Orthodontia services for adults – a benefit not available under the state sponsored plan!
- $1,250 annual maximum in TPEA’s plan can grow to $2250 – potentially exceeding the state plan by $750!
- Enhanced benefits after 12 months on ALL covered services
- No waiting periods for any dental services! (Orthodontia services excluded for twelve months)
If you have questions concerning the new TPEA Ameritas dental insurance plan, or to locate a network dentist, call 1-888-239-3336 or visit them online at www.ameritasgroup.com/resources/find.asp.
Vision Service Plan
Download information sheet (requires Adobe Reader)
VSP provides coverage for lenses, and frames - the state plan does not!
The TPEA VSP Plan Offers:
- Comprehensive eye exam with no co-pay!
- Lenses are covered in full!* – Again, not available under the state sponsored plan!
- Frames covered up to your allowance. * Or, choose to apply frame benefit for contact lenses.
With the TPEA vision plan, you’ll save! Without VSP, you can expect to pay an average $216.73 for single vision glasses, and $253.51 for bifocal glasses. To locate a VSP doctor in your area, call 1-800-877-7195 or visit www.vsp.com/go/TPEA.
Other Benefits Not Available Through the State
There are other benefits in the TPEA package that are not available through the state.
Final expense life insurance. You can have peace of mind knowing that your premiums are guaranteed never to increase, and your coverage is guaranteed never to decrease. Death benefits paid to your beneficiary are tax free.
Medical Air Transportation Services. Over the past 30 years Medical Air Services (MASA) has become an international company dedicated to providing life saving emergency assistance. The coverage is designed to protect members against catastrophic financial loss when emergencies arise. The Platinum Membership offered through AMBA offers the following 13 services: Emergency Air Transportation, Helicopter Transportation, Ground Ambulance Transportation, Organ Retrieval, Organ Recipient Transportation, Recuperation/Repatriation, Return Transportation, Escort Transportation, Non-Injury Transportation, Minor Children/Grandchildren Return, Mortal Remains, Vehicle Return, and World Wide Coverage.
Long Term Care/Home Health Care. AMBA will build a policy to match your own needs. You select the daily benefit amount, elimination period, and benefit period which best suits your needs for care. AMBA endorsed Long Term Care Policy features include: no prior hospital stay; no waiting period for pre-existing conditions; pays in addition to your other insurance, and no premium increases with age.
Long Term Care Annuity. The Long Term Care Annuity combines a deferred fixed rate annuity with a built-in long term care rider. This annuity can provide you up to three times the annuity value in long term care benefits if you need them.
Tax-Deferred Annuity. AMBA offers a Single Premium Tax-Deferred solution for your retirement featuring tax-deferred accumulation of interest, guaranteed competitive interest rate, multiple payout options, and a nursing home waiver.
First Diagnosis Cancer Plan. The First Diagnosis Cancer plan pays money directly to you in cash at one time in one lump sum payment upon first diagnosis of Internal Cancer or Malignant Melanoma you can select the lump sum payment of $10,000, $20,000, $30,000, $40,000, or $50,000 that best fits your needs.
First Diagnosis Heart Attack & First Major Heart Surgery. The First Diagnosis Heart Attack and First Major Heart Surgery plan pays money directly to you in cash at one time in a lump sum payment upon first diagnosis of a heart attack. You can select the lump sum payment of $10,000, $20,000, $30,000, $40,000, or $50,000 that best fits your needs. A stroke rider is available.
Medicare Supplement Insurance Plans. The Senior Class Medicare Supplement Plan offers Medicare Plans A, B, C, D, F, G and J. Senior Class Plans pay for eligible expenses not paid by Medicare, and gives you the freedom to use your own physician, specialist, and medical facility.