There are NO WAITING PERIODS for preventive and basic dental care! There is a 12-month waiting period for major dental care for those who are enrolled in any of the plans. Waiting period for major services may be waived with proof of prior coverage provided by the member. All benefits begin on your effective date.
Anyone age 18 and older in an approved state is eligible for coverage. You can request coverage for your dependent; dependent eligibility varies based on state law.
You’ll receive a 30-day notice prior to any rate change (more if required by state law).
Member ID cards are generated and sent electronically upon enrollment. If you need a new one or have lost it, you can log onto the portal to obtain a replacement or call 1(346)-460-5451
To receive a refund, submit a written or verbal notice of cancellation to our office within 30 days of the effective date. No refunds are offered after the 30 days. To cancel please submit written or verbal notice to our office. All cancellation requests will be effective on the next billing period.
For Claims call FCL at: 1(877) 493-6282. Other questions contact Care Customer Service at: 1(346)-460-5451
Yes! The dental plan you currently have in force will be the primary dental plan and the Apex dental plan will be the secondary dental plan. The insurance carriers will coordinate the payments of dental claims.
Yes! You would simply purchase the Apex dental plan for your spouse and/or your children.
Those benefits are covered under major services at 50%. There is a 12 month waiting period unless you have had a qualifying dental plan the previous 12 months. Apex will ask for a Certificate of Credible Coverage. Example: If you were on a prior dental plan for only 6 months then you would have a 6 month waiting period on major services.
All benefits reset after the first of the year. This is what they call a Calendar year dental plan. Plan benefits run January 1st to December 31st. Example: The new dental plan starts September 1st. This means if an individual has chosen the $5,000 benefit it will run until the end of the year and then the benefits starts over January 1st through December 31st with another $5,000 benefit for the plan year.
This plan election can only take place on the anniversary of your enrollment (your effective date).
If you use an in-network dentist, the dental office files all the paperwork for you. All dental plans have a $25 office co-pay and benefits are paid according to the description of benefits. There is no filing for claims reimbursement.
Yes, this is a MAC plan. A MAC plan is a type of PPO plan where you receive greater benefits and less out of pocket expense by going to an in network provider. Services completed by an out of network provider will most likely incur beyond what the contracted provider would charge for the same procedure.
12 months after the date of termination of your plan.