Members

IMPORTANT INFORMATION FOR MEMBERS WITH INDIVIDUAL OR FAMILY DENTAL PLAN (START DATE OF JANUARY 1, 2014)

Deductibles, Coinsurance and "Roll Overs"
  • In most cases, members are responsible for deductibles and coinsurance at the time services are performed.
  • If you met your deductible on another dental plan, you cannot receive credit toward this plan’s deductible.
  • With Gold or Gold Plus Vision, you may "roll over" a portion of your unused maximum benefit to the next year ($350) if you submit at least one claim during the year and your total claims do not exceed $500 for the year.
Dependent Coverage
  • Stepchildren are eligible for coverage.
  • Single, dependent children are covered to age 26 as long as premiums are paid when due.
Payment of Premium
  • Members have a "grace period" of 31 days to pay a premium after it is due. However, if the payment is not received, the policy will be terminated on the date the premium was due.
  • For members who enrolled through the Health Insurance Marketplace and applied a portion of their Advance Premium Tax Credits (APTC) toward the payment of their premium, a grace period of three consecutive months will be granted for the payment of premiums after receipt of the first month’s premium.
  • If your policy cancels for non-payment of premium, it may be reinstated within 60 days if the premium is paid (certain rules may apply). To get your policy reinstated and pay your premium, call 1-800-238-8379. (Reinstatement policy does not apply to policies purchased through the Health Insurance Marketplace.)
Waiting Periods
  • Pediatric Minor and Major Restorative Services are not subject to waiting periods.
  • Adult members enrolled in Dental Silver will have the 6-month waiting period for Minor Restorative services. The waiting period will be waived if the follow criteria is met:
    • The application is received within 30 days of the termination date of the member’s previous coverage; and
    • No later than 30 days from the effective date of the new policy with Arkansas Blue Cross and Blue Shield, the member provides us with:
      • A copy of the member’s previous dental policy Certificate of Coverage which reflects the policy's effective and termination dates; and
      • A copy of the member’s previous policy's benefit schedule which reflects at least six months of coverage for Minor Restorative services.
  • Members enrolled in Dental Gold or Gold Plus Vision will have the 6-month waiting period for Minor and Major Restorative services waived if the follow criteria is met:
    • The application is received within 30 days of the termination date of the member’s previous coverage; and
    • No later than 30 days from the effective date of the new policy with Arkansas Blue Cross and Blue Shield, the member provides us with:
      • A copy of the member’s previous dental policy Certificate of Coverage which reflects the policy's effective and termination dates; and
      • A copy of the member’s previous policy's benefit schedule which reflects at least six months of coverage for Minor and/or Major Restorative services.
Other Things to Know
  • Monthly premiums can automatically be deducted from your bank account. Call 1-800-238-8379 for more information.
  • Orthodontic services are not covered.
  • If you visit a nonparticipating dentist and need to have your claim processed, please mail your claim form to:
    Dental Claims Administrator
    P.O. Box 69436
    Harrisburg, PA 17106-9436