Visit us at www.sunlife.com/us. We adhere to quality standards encompassing a broad range of care and service issues that are the cornerstone of our Quality Assurance Program (QAP). 2022 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. It typically takes two or more weeks to process a pre-estimate. If you choose to refer a patient to an out-of-network specialist, you may do so, but we request that you inform the patient that they have the option to be referred to an in-network specialist if they desire. 2022 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. Please call Client Services at800-443-2995. Register and/or log in today to access your benefits online! In New York, prepaid dental products are provided and administered by Sun Life and Health Insurance Company (U.S.) (Lansing, MI). This dental insurance plan provides variety of benefits and allows you and your family to use any dentist or specialist you choose. You may not have realized that Sun Life has over three decades of experience offering comprehensive dental plans. Kansas City Life Insurance Company . In New York, group insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Lansing, MI). In New York, insurance products and prepaid dental products are underwritten or provided by Sun Life and Health Insurance Company (U.S.) (Lansing, MI) ("SLHICUS") or by Union Security Life Insurance Company of New York (Fayetteville, NY . If their plan reimburses dental claims based on the current year fee guide, they might want to have options to limit the cost increase in 2021 (for ASO) or at their next renewal (for insured). $1,500 calendar year maximum Sun Life Assurance Company of Canada. Plans with a Specialty Benefit Amendment, allows the member to receive specialty care from a specialist who participates with the plan or from an out of network specialist. 2 Sun Life's dental networks include its affiliate, Dental Health Alliance, L.L.C. How do I find out about coverage, deductibles, co-pays and maximums for your patients? What is the Specialty Benefit Amendment (SBA)? What states are the Prepaid Dental Plans available in? 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Yes. Visit us at www.sunlife.com/us. Please consult your plan materials or call Client Services at800-443-2995for assistance. How do I submit a claim for one of your patients? DENTAL Prepaid Plan - 2023 How the plan works You pay reduced fees called "copayments" for dental services provided by a network provider (Plan Dentist). Enroll now . You can call Provider Relations at 800-434-2638 from 7:00 a.m. to 4:30 p.m. CT , Monday through Friday.. Who do I call if I have questions regarding my Personal Fee Profile? INDIVIDUAL PLAN FEES monthly $10.40 -OR- $109.82, once annually (Save $14.98*) INDIVIDUAL +1 PLAN FEES monthly $16.74 -OR- $185.86, once annually (Save $15.02*) FAMILY PLAN FEES monthly $25.68 -OR- $293.15, once annually (Save $15.01*) We encourage you to refer to this information for any questions you may have. | Website Terms and Conditions | Designed by Sagapixel. Learn about the federal COVID-19 legislation updates and the state of the 2020 presidential election. The member pays any applicable copayment(s) at the time of treatment according to the Copayment Schedule. 2022 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. Representatives are available to assist you Monday through Thursday from 7:00 a.m. to 7:00 p.m. CT and on Friday from 7:00 a.m. to 5:50 p.m. at800-443-2995. The full increase in cost will show in the plans experience and will impact the next renewal or their first ASO bill of 2021. 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Visit us at, $50 per person/$100 per family (applies to type 2 and 3 services only), Brush biopsies for early cancer detection, minor treatment to control harmful habits, other x-rays (see certificate of insurance), simple extractions, removal of exposed roots, incision and drainage, certain lab tests, pain treatment, therapeutic drug injections, endodontic treatment(Root Canal Treatment), provisional splinting, occlusal adjustments, gingivectomy, osseous surgery, other major periodontic procedures, initial placement, replacement and maintenance of inlays, onlays, crowns, fixed partial dentures (bridges), and partial and complete dentures, harmful habit appliance (children under 16). Whichever plan you choose, the low monthly rate and out-of-pocket costs will give you many reasons to smile. 2022 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. Email:SLFGRIEV@sunlife.com. Our Secure Choice Dental plans are available for families, singles and retirees who are looking for an affordable dental plan. Claims should be submitted with your usual fees, not the network fee listed in your personal fee profile. All rights reserved. Plus, each plan includes plenty of extra benefits such as teeth whitening and bonding, along with: Sign up today. The Sun Life name and logo are trademarks of Sun Life Assurance Company of Canada. United Concordia Inc. . SHARE The following monthly costs are effective 1/1/2023 - 12/31/2023 No, the copayments listed on the Copayment Schedule are the full amounts the member is responsible to pay to the Plan Dentist. Well also update the inflation factor in our renewals that are due on February 1, 2021. (Save $15.01*) For the dental care you need at a price you can afford, choose the Secure Choice Dental Plan that is right for you. (SBA), an member is responsible for the discounted fee as listed in the copayment schedule. As an experienced dentist with over 40 years managing his own dental practice, Dr. (English / Espaol). Is there a fee to join your PPO networks? The patient's responsibility is the difference paid by us and the fee for the service actually performed. All rights reserved. If I have a problem with a claim from another company that uses the DHA network, whom do I call? 2022 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. The State of Florida offers you comprehensive dental coverage through an array of dental plans. Do plan members have to select my facility to be on my roster? The Connecticut Dental Health Partnership is the Dental Plan for HUSKY Health and is administered by BeneCare Dental Plans under a contract with the CT Department of Social Services. Our Secure Choice Dental plans keep you smiling. Our PPO networks include dentists contracted with Dental Health Alliance, L.L.C. (DHA) and dentists under access arrangements with other dental networks. All eligible members will receive an identification card listing their PPO network. To access all of the tools we have available for our dentists, including the DHA Dentist Guide, please login with the username and password that was provided in the acceptance letter you received. The evolving world of gene therapies: What employers need to know today, tomorrow and beyond! How long does it take to process pre-estimates? Visit us at www.sunlife.com/us. .$31 D0145 Oral evaluation for a patient under three years of age and counseling with primary Limitations and Exclusions Youll like the affordable monthly rates and the out-of-pocket costs. Discount applies to select full dentures or implant prosthetics only and not to related dentistry services, if any. Are there fees assessed for payments by Virtual Credit Card? Contact the benefits administrator at the phone number on the patient's dental ID card. Prepaid dental products are provided by Sun Life Assurance Company of Canada (Wellesley Hills, MA), under Form Series BDC-IDSA. Questions? No referral is necessary. Feel free to co-brand the flyer by adding your logo or practice name in the upper right corner. Dental Provider Portal: $293.15, once annually. Group insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states except New York. Fee guide of current year minus X% - for example, a plan sponsor could choose to cover the 2021 fee guide minus 2%. How do I join your PPO networks? Plus, each plan includes plenty of extra . Services not listed on the Copayment Schedule are not covered by the Plan. Fee guide of previous year for example, if the contract currently covers the current year fee guide, this would mean that the plan would stay at the 2020 fee guide in 2021. How will I know when a patient participates in one of your PPO networks? For assistance, call the Provider Enrollment Helpline at 1-844-4MD.PROV (1-844-463-7768) or email MDProviderRelations@automated-health.com . Whats important to know is that some of these increases are higher than what weve seen in the past. Sun Life /Grievance Department Sun Life UnitedHealthcare Plan River Valley, Inc. UnitedHealthcare of Alabama, Inc. UnitedHealthcare of Arizona, Inc. UnitedHealthcare of Arkansas, Inc. We also direct patients to participating providers via telephone referrals through our Client Services lines. Many plans contain a provision, which limits the amount of reimbursement for a procedure to the amount available for the least costly alternate treatment for that dental problem or disease. For more information and resources on how to use ePREP, visit New Provider Enrollment Portal - ePREP., For dental providers who want to participate in the Maryland Healthy Smiles Dental Programas an individual provider or group practice, complete aMedicaidprovider application at ePREP.health.maryland.gov. Provincial dental fee increases for 2022 It's that time of year when most provincial and territorial dental associations release their annual fee guides. Yes, we accept electronic attachments. Aspen Dental offices make flexible . We market Prepaid Dental Plans in the following states: Alabama , Arizona , California , Colorado , Florida , Georgia , Illinois , Kansas , Kentucky , Missouri , Nebraska , New Jersey , New Mexico , New York , Ohio , Oklahoma , Pennsylvania , Tennessee , Texas , Utah , and Wisconsin . Sun Life Family Dentistry Sliding Scale Low Cost. FAMILY PLAN FEES. This way, the plan takes on part of the increase and 2% passes on to the plan member. If you are a Maryland Healthy Smiles provider and need to be credentialed, update your license expiration or update yourdemographic information, visit ePREP.health.maryland.gov. We currently offer dental plans in the following states. Visit us at, Participating and adjustable policyholder information, Your Rights and Protections Against Surprise Medical Bills, The dos and donts of mandatory COVID-19 vaccines, Mask requirements in the evolving vaccination workplace, Looking to improve Cardiac outcomes in Disability, Mental Health in the Workplace: It Starts at the Top with Regular, Real Required Conversations. A complete description of insured benefits, including limitations and exclusions, will be provided in the Certificate of Insurance. In all instances, you are limited to the charge stated in your Personal Fee Profile. This dental plan does not provide coverage for pediatric oral health services that satisfies the requirements for minimum essential coverage as defined by the Patient Protection and Affordable Care Act. (English / Espaol). (800) 277-3633. Heres how you canprotect yourselfand what to do if yoususpect fraud. When specialists are required, we recommend that referrals be made to a participating specialist in their PPO network so that patients can take full advantage or their in-network benefits. www.ctdhp.org and www.ctdhp.com are official websites for The Connecticut Dental Health Partnership. How is Sun Life helping members maintain coverage? In that case, we'll continue to pay dental claims in alignment with the fee guide in their contract. Who do I contact if I have questions regarding my responsibilities with your PPO Networks? How do I know if I have the most current version of the plan Copayment Schedule(s)? Schedule appointment. Your dentist will give you a comprehensive exam and recommend treatment to get your mouth on the road to healthy. Our PPO dentists are allowed to bill the patient for the service actually performed. No communication to plan members will be required. Level Inc. . Typical Dental Plan Benefits and Limitations. HUSKY Health Dental ProvidersNEWS and INFO. If you have a question about member benefits or the eligibility of a specific patient, please contact Client Services at800-443-2995. The credentialing process is based on standards developed by the National Committee for Quality Assurance (NCQA) and industry standards. Group insurance policies are underwritten by Sun Life Assurance Company of Canada (SLOC) (Wellesley Hills, MA) in all states, except New York. Get in today for a limited-time deal on dentures and implant dentures. Maximum Allowable Charge plans. If those services are necessary, you may bill the patient at your normal retail charge. Have immediate access to your plan information; View and/or print personalized dental ID cards; View and/or print benefit information pages; View most recent dental visits and procedures; View and/or print booklets All rights reserved. Yes, members need to select your facility to be listed on your roster to receive benefits based on the Copayment Schedule. A pre-estimate is not required but encouraged in order to avoid any confusion about the amount of plan benefits that would be paid. In New York, insurance products and prepaid dental products are underwritten or provided and administered by Sun Life and Health Insurance Company (U.S.) (SLHIC) (Lansing, MI). In certain states, prepaid dental products are provided by prepaid dental companies affiliated with SLOC. Well follow our standard practice and communicate with plan sponsors in Q1 2021 once all provincial fee guides have been published. Kansas City, MO 64179-0155, FAX: 855-303-3908 Product offerings may not be available in all states and may vary depending on state laws and regulations. Administrative Services Only plans. Typically, there's an increase in costs across the board. Product offerings may not be available in all states and may vary depending on state laws and regulations. Can I send electronic attachments? 1 Zelis Network Analytics data as of January 2022 and based on unique dentist count. It looks like your browser does not have JavaScript enabled. The State of Maryland pledges to provide constituents, businesses, customers, and stakeholders with friendly and courteous, timely and responsive, accurate and consistent, accessible and convenient, and truthful and transparent services. Provider complaints regarding an administrative, payment, or other dispute between the participating provider and the Plan that does not involve a utilization review analysis and does not include routine provider inquiries that the carrier resolves in a timely fashion through existing informal processes should be sent to: This dental plan does not provide coverage for pediatric oral health services that satisfies the requirements for minimum essential coverage as defined by the Patient Protection and Affordable Care Act. There is no fee to join our PPO networks. This dental plan does not provide coverage for pediatric oral health services that satisfies the requirements for minimum essential coverage as defined by the Patient Protection and Affordable Care Act. All rights reserved. Am I allowed to bill the patient if a service is not paid by you? We offer the Star Life Dental Network and Sun Life Focus Network . Box 2940 OR Celebrating 25. years of smiles. Am I required to refer patients to specialists in a patient's PPO network? This number can typically be found in communications sent regarding your employer plan, on dental ID cards, or within our Benefit Tools mobile app. No referrals or authorization is needed for the prepaid plans. What am I allowed to bill the patient when you apply the alternate benefit provision? A plan member must select a plan-participating facility and utilize that facility in order to receive benefits. December 19, 2022 2023 Dental Fee Guides Every year, provincial and territorial dental associations release their annual fee guides. These fee guide changes will impact experience that will be taken into account at their next renewal. The Sun Life name and logo are registered trademarks of Sun Life Assurance Company of Canada. Sun Life and the globe symbol are trademarks of Sun Life Assurance Company of Canada. How can I have a specialist, to whom I refer, added to the network? The member should call Client Services to request assignment to your facility. For the dental care you need at a price you can afford, choose the Secure Choice Dental Plan that is right for you. Our PPO networks were created by dentists for dentists and have become some of the nation's largest national preferred provider organizations. If you are a broker, do you sell group or individual insurance. The Sun Life name and logo are registered trademarks of Sun Life Assurance Company of Canada. We're here to help. Dental benefits vary widely between carriers, but there are certain restrictions and limitations that are fairly common. Sun Life Dental Transamerica - National PPO Which partners lease the Dental Benefit Providers of California, Inc. network? With the New Year around the corner, provincial dental associations have started to publish their fee guides and many include increases for 2021, as they normally do. Additionally a request must . Group insurance policies are underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA) in all states, except New York, under Policy Form Series 15-GP-01 and 16-DEN-C-01. Learn about the federal COVID-19 legislation updates and the state of the 2020 presidential election. 2 Sun Life's dental networks include its affiliate, Dental Health Alliance, L.L.C. JavaScript is required to use content on this page. Its the only way a candidate can apply to a role at Sun Life. Please review all of the options available to determine the best one for you. 1The Sun Life Focus Dental Network is only available for policies issued in North Carolina. What happens if the procedure I performed is not listed on the Copayment Schedule? If I have a problem with a claim from you, which number do I call? Sign up for the PEF Retirees Dental plan (Group Number 935636) by calling: 844-738-8118, Monday through Friday, 8:00 a.m. to 8:00 p.m. Typically, there's an increase in costs across the board. HUSKY Health MembersCall 855-CT-DENTAL (855-283-3682)to FIND A DENTIST onlinehere. NEWS and INFO. Heres how you canprotect yourselfand what to do if yoususpect fraud. We dont ask for payment or deposit as part of our recruitment process. Prepaid dental products are provided by Sun Life Assurance Company of Canada (Wellesley Hills, MA), under Form Series BDC-IDSA. new fillings: replacement fillings simple extractions, removal of exposed roots, incision and drainage certain lab tests, pain treatment, therapeutic drug injections endodontics (Root Canals) endodontic treatment (Root Canal Treatment) Type III major dental services, including: Complete X-Ray Series, including Bitewings, Routine Cleaning - Adult (once every 6 months), Benefits are payable for pre-existing conditions within the copayment schedule. Prepaid dental products are provided by Sun Life Assurance Company of Canada (SLOC) (Wellesley Hills, MA), under Form Series BDC-GDSA. Call 855-CT-DENTAL (855-283-3682) to FIND A DENTIST online here. Slo haga clic en TRANSLATE en la barra azul de arriba, 2023 The Connecticut Dental Health Partnership. Our plan flexibility offers competitive dental benefits without sacrificing excellent service. For assistance, call the Provider Enrollment Helpline at 1-844-4MD.PROV(1-844-463-7768)or emailMDProviderRelations@automated-health.com. Visit us at www.sunlife.com/us. To initiate a fee guide change, you need to contact your Account Executive. Here are the fee guides that have been issued to date: To help plan members continue to have access to the dental care they need, well update our system with the 2021 fee guides. Indemnity w/ PPO (4084) Type I: Preventative Services (Routine cleanings, X-rays, etc.) Companies that access DHA through the Dental Benefits Providers, Inc. access arrangement. Visit us atwww.sunlife.com/us. If services not listed on the Copayment Schedule are necessary, you may bill the patient at your normal retail charge. Some prepaid plans, (DHMO series plans), include a third payment based upon the services provided. Additionally a claim must be . In an instance where a DentalSave published fee is equal or greater than the dentist's normal fee, the participating dentist will provide an extra 25% off their normal fee. Product offerings may not be available in all states and may vary depending on state laws and regulations. 5 Averages based on 2022 Q2 Sun Life internal data. If you need to obtain the username and password, please call us at 800-522-1313. For plans that do not have the SBA, the member is entitled to a discount of 25%, (15% for endodontic specialty). Our fax line for pre-estimates is 563-242-0184. As part of your welcome notification, you were provided a copy of your Participating Dentist Agreement and your Personal Fee Profile. Voluntary plans. Members who werein the adult dental pilot are eligible under the adult dental expansion. Dual Select plans. Sometimes additional information is needed, so it is helpful to submit all appropriate documentation when filing a pre-estimate. Dental provider frequently asked questions, Preferred Provider Organization (PPO) topics, Participating and adjustable policyholder information, Your Rights and Protections Against Surprise Medical Bills, The dos and donts of mandatory COVID-19 vaccines, Mask requirements in the evolving vaccination workplace, Looking to improve Cardiac outcomes in Disability, Mental Health in the Workplace: It Starts at the Top with Regular, Real Required Conversations. The credentialing process is based on standards developed by the National Committee for Quality Assurance (NCQA) and our provider network.

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