Taking proper care of your teeth and gums requires more than brushing and flossing every day. You also need to see a dentist at least twice a year for a thorough cleaning and check-up. Without dental insurance, the cost of these procedures can quickly add up. Also, when dental incidents arise and you need more treatment to your teeth and gums than simple preventative measures, you could be looking at a very high bill.
Dental insurance helps pay for some, most or all of the cost associated with dental procedures. By participating in the group dental insurance plan, you are provided access to care from a variety of network dental providers with a rich benefit plan.
Eligibility: This coverage is available to full-time employees (working in excess of 30 hours per week) during the first 31 days of employment, during open enrollment periods, and for qualifying events.
Eligible Dependents: Spouse and dependent children to age 26.
Effective Date: Coverage is effective the first day of the month following date of employment.
Coverage Options: Company pays the entire premium for coverage on the full-time employee; however, the employee may choose to cover one additional person or their entire family at an additional cost to the employee as outlined below.
A: You may go to the dentist of your choice. However, your out-of-pocket expense is less when you use an in- network provider. The plan will pay 90% of basic dental services for in-network providers and 80% for out-of-network providers.
In-network providers offer employees discounts ranging from 20-35%. If you select a provider who is not in the network, that provider can bill you for any amount not covered by the plan benefits. You will be responsible for the difference between the billed charges and the maximum allowable charge for a covered service.
A: The dental and vision plan year is based on the calendar year from January 1 to December 31. Deductibles reset on January 1.
A: Print and complete the Dental Claim Form only for out-of-network services and materials. The Insurance Company will only accept itemized paid receipts. Return the completed form and your itemized paid receipts to:
A: You can add/drop dependents from your insurance if you have a qualifying event. A qualifying event is marriage, divorce, death, birth or adoption of a child, or change in spouse’s job (e.g. if a spouse had medical insurance coverage with their employer and then accepted another position with an employer that did not offer insurance, the spouse could be added to The Company employees insurance).
You will need to complete an Enrollment/Change Form within 30 days of the qualifying event (birth/adoption of a child has a 60-day change period). If the change is due to spouse’s job, attach a letter from the spouse’s employer indicating when the coverage will end/begin.
In the case of divorce, a copy of the divorce decree will need to be provided. In the cases of marriage, a copy of the marriage license will need to be provided.
A: You will receive one card for medical, dental, and vision. It will be mailed to your home address. Contact theinsurancecompany.com or call 1-800-123-4567 if you need a replacement card or additional cards.
Click on the link below to review the Dental Plan information for Employees: