DOCUMENTS & FORMS
Navia Benefit Solutions
Dental and Vision Plans
DENTAL & VISION REIMBURSEMENT PLAN
Navia Benefit Solutions is proud to be the administrator of your dental and vision reimbursement plan. This reimbursement plan has been established by the City of Burlingame to reimburse you and your family for dental and vision expenses.
Plan Year: January 1, 2020 – December 31, 2020
Eligible Expenses: Dental and vision expenses. Services that are cosmetic (e.g. teeth whitening, veneers) or hygienic (e.g. toothpaste, toothbrushes) in nature are not eligible for reimbursement. Eligible services must be incurred during the plan year.
Employee Dental Plan (Orthodontic included) – Employees reimbursed up to $2,500 per year.
- AFSCME 829, ASFME 2190, Unrep/dept heads/council, BAMM, Teamsters
Dependent Dental Plan 3000 – Dependents reimbursed up to $1,500 per year for each dependent, not to exceed $3,000 cumulative for all dependents.
- AFSCME 829, ASFME 2190, BAMM, Department Heads/Unrep, Council, Teamsters (optional)
Employee Vision Hardware & Employee Vision Exam – Employees reimbursed up to $1,000 for hardware; $200 for an eye exam per year.
- All Employees
Dependent Vision Plan – Dependents reimbursed up to a cumulative amount of $600, including eye examinations. All employees are eligible.
- Al Employees
HOW TO USE YOUR BENEFIT
Once you’ve incurred a service and your patient responsibility has been determined, you may submit a claim to Navia for reimbursement. It is your responsibility to pay your service provider.
- Obtain supporting documentation showing the date, type, and cost of service. Ideal forms of documentation include an itemized statement from the provider of service, or an explanation of benefits (EOBs) if the expense was covered under insurance.
- Submit the claim form and supporting documentation to Navia. The most efficient way to submit a claim is by uploading it online, or with the Mynavia app for Android or iPhone. You may also submit by email, fax, or mail. Please use only one method per submission. Allow at least 2 full business days for your claim to be reviewed and processed once it has been received.
- Reimbursements are processed weekly on Mondays. Your reimbursement will be directly deposited into your bank account, or a check will be sent to your home. Note that bank deposits may take 1-2 days to post to your account.
- You will have 90 days to submit claims at the end of the plan year. In the event that your employment is terminated or you lose coverage, you will have 90 days to submit claims for expenses incurred prior to your plan termination date. You may have the ability to continue coverage under COBRA (see your employer for details).
Navia Benefit Solutions