Group Dental Insurance Plan FAQs
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When is my coverage effective?
When does the coverage terminate?
What if I have second thoughts after I enroll?
The Plan provides benefits for diagnostic and preventive care as well as almost every form of specialty dental treatment. You may go to any dentist you wish. The Schedule of Dental Services identifies the maximum allowable benefit you and your dependents receive when a procedure is performed. The dollar amount assigned to each procedure is the maximum you receive, not to exceed actual charges. Under this Plan, you can have benefits paid either directly to the dentist or you can be reimbursed for the benefit. |
You and your eligible dependents may enroll for coverage. Eligible dependents include a lawful spouse and dependent children typically under age 21 (age 25 if a full-time student). Subject to state variations. |
You and your covered dependents are entitled to receive up to $1,000 each in benefits per calendar year after the cash deductible is satisfied. |
For all services, a deductible of $50 per insured person is required per calender year, up to $150 maximum per family unit. The deductible is applied against insurance covered, not billed charges. |
Your coverage will be effective the first day of the month following receipt of your enrollment form and first premium. Some services are subject to a six- or 12-month waiting period; see "What is the waiting period?" |
Preventive, Diagnostic, Restorative (except major) and Adjunctive Services are provided immediately. Endodontics and Oral Surgery have a 6-month waiting period. All other benefits have a 12-month waiting period. Once you have been enrolled under the plan for 12 consecutive months, you are eligible for benefits under Restorative-Major, Periodontics, Prosthetics-Removable and Fixed Bridge. |
You are able to choose between three premium payment options, whichever one best suits your needs:
All billing modes except annual will include a $2.00 billing fee. To avoid the fee, select EFT as a safe and secure payment option. Rates will not be changed unless they are changed for all insureds within your classification. |
Your dental coverage will be terminated if you cease to be a member of your association;
you fail to pay the appropriate premium when due; or the group policy is discontinued.
Coverage for dependents will end if your insurance ends, dependents’ insurance
ends under the group policy, the policy ceases to be a dependent or premium is
not paid for the dependent when due. All persons who were previously insured
for dental insurance under this plan and later voluntarily ended insurance will
not be eligible to en-roll for a period of two years following the date insurance
was voluntarily ended. |