Group Dental Insurance
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You know how important a quality health plan is to help protect you from rising medical costs — but what about dental protection? Without a comprehensive dental plan, you may end up paying hundreds, possibly thousands of dollars out of your own pocket each year.

Luckily, for AFSA members, there's a solution — the AFSA Group Dental Insurance Plan. This solid insurance protection gives you the outstanding benefits you need at a price you can afford.

As a member of AFSA, you are entitled to enroll for quality Dental Insurance at economical group rates. AFSA has negotiated these economical group rates for a Dental Plan that includes:

  • You are GUARANTEED ACCEPTANCE
  • You'll pay economical group rates
  • Your entire family is eligible
  • Your benefits can be paid directly to you or the dentist
  • Benefits for over 155 dental services
  • Freedom to choose any dentist you want
  • The Plan is portable, it goes with you even if you change jobs
  • Even bigger savings when you choose a dentist in our SmileMax® Network
  • Includes Orthodontics for children under age 19

Your dental health is just as important as your physical health, insure yourself and your family with this important coverage. Visit the Plan Details section to learn more about this plan then enroll for coverage today.

This plan is underwritten by The United States Life Insurance Company in the City of New York, NAIC No. 70106 domiciled in the state of New York with a principal place of business of 175 Water Street, New York, NY 10038. It is currently authorized to transact business in all states, plus DC, except PR.

Policies issued by The United States Life Insurance Company in the City of New York (US Life). Issuing company US Life is responsible for financial obligations of insurance products and is a member of American International Group, Inc. (AIG). Products may not be available in all states and product features may vary by state. Policy # G-227,633 Form # G-19000.

This summary is a brief description of benefits only and is subject to the terms, conditions, exclusions and limitations of the group policy.

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Plan Details

You, your spouse and children are guaranteed acceptance.

You, your lawful spouse and dependent children (typically under age 21 or age 25 if full-time student) are guaranteed acceptance—there are no long forms to complete, dental health questions to answer or exams to take. You’re already in (subject to state variations).

Benefits provided for 155 different dental services.

This Group Dental Insurance Plan is not a discount type plan you can get elsewhere. This plan provides comprehensive coverage for more than 155 different dental services, including diagnostic, preventive and specialty dental treatments. Click to display the Schedule of Dental Services.

You have freedom to choose any dentist you want.

With many employer-provided or other types of dental plans, you’re required to use networks, preferred lists or referrals for specialty treatment. But with this Group Dental Insurance Plan, you can choose to use your own dentist.

No waiting period for preventive, diagnostic restorative or adjunctive services.

Preventive, diagnostic, restorative (except major) and adjunctive services are all provided immediately with no waiting periods. However, to keep your rates economical, there is a 6-month waiting period for endodontics and oral surgery services; a 12-month waiting period for all other services. After 12 consecutive months of coverage, you qualify for restorative-major, periodontics, prosthetics-removable, and fixed bridge services. For orthodontics services for insured dependent children under age 19, there is a 12 month waiting period.

Benefits can be paid directly to you or your dentist—it’s your choice.

You can choose to have your benefits paid directly to you or to your dentist, whichever you prefer.

Option to use the SmileMax® Dental Network which can result in lower out-of-pocket costs for your dental care
This Dental Plan includes an optional PPO feature through the SmileMax® Dental Network which can help reduce your out-of-pocket expenses. The SmileMax® network is a group of dental professionals at more than 140,000 locations nationwide that have contracted to provide dental services at negotiated fees. Selecting a network dentist can also help ensure quality care, because all network dentists are screened according to a rigorous credentialing process. Members are encouraged to use a network dentist in the SmileMax network when accessing dental services. When a network dentist is selected, you will be charged pre-arranged fees that are guaranteed to be at or under the dentist’s usual fee. On average, a savings of 20 to 40 percent have been achieved nationally when using a network dentist. This Dental Plan will continue to pay at the levels shown in the Schedule of Dental Services and you will be responsible for the difference between the network dentist’s negotiated fee and the amount paid by this plan. But your out-of-pocket costs will be significantly reduced because the network dentist’s negotiated fee is less than the dentist’s usual fee. You may continue to choose any dentist you wish. However, using a SmileMax network provider can help you save significantly. To find a SmileMax dentist, call 1-800-221-3480 or visit SmileMax Dental Provider, an online search tool. If your dentist does not currently participate in the SmileMax® Dental Network, you can contact the program administrator to obtain a nomination form to nominate him/her for membership.

Deductible of $50/person or $150/family unit, per calendar year.

For all services, there is a deductible of $50 per insured person/$150 per family unit, per calendar year. The deductible is applied against insurance-covered expenses, not billed charges.

You and your covered dependents are entitled to receive up to $1,000 each in benefits.

You and your covered dependents are entitled to receive up to $1,000 each in benefits per calendar year, and up to $850 lifetime maximum for orthodontic services after the deductible is satisfied. Coverage for orthodontic services applies only to insured dependent children under age 19.

Your coverage will be effective the first of the month following receipt.

Your coverage will be effective the first of the month following receipt of your enrollment form and first premium payment.

You can choose between three premium payment options, whichever one best suits your budget.

  • Automatic monthly check withdrawal, which saves you time and money on checks and stamps and remembering payment due dates.
  • Credit card payment on a quarterly basis.
  • Direct bill on a quarterly basis.

If applicable, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option.

Economical group rates.

Because you’re an association member, you qualify for members-only group rates.

Your coverage will terminate only if you cease to be a member of your association.

Your coverage will terminate only 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 your dependents will be end if your insurance ends, dependents’ insurance ends under the group policy, the person 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 end insurance will not be eligible to re-enroll for a period of two years following the date insurance was voluntarily ended.

Exclusions keep your rates economical.

To keep your rates economical, there are some things the plan does not cover. To see the full list of exclusions this plan does not cover, see 'Exclusions' below.

Goes with you wherever you go—change jobs, move, etc.

With this Group Dental Insurance Plan, it goes with you wherever you go—whether you travel, plan to move or switch jobs in the future.

Enroll conveniently right now—no salesperson will contact you.

It’s easy to enroll in your association Group Dental Insurance Plan. Everything is handled the modern, convenient way through this secure site. No salesperson will call you. You can also visit the Forms section to download a no-obligation enrollment form and brochure containing detailed plan information and plan provisions, including costs, exclusions, limitations and terms of coverage.

Once you receive your Certificate of Insurance, if you're not satisfied within the first 30 days, we'll send you a full refund of any premiums paid during that period and your certificate will be considered never issued. You will be under no further obligation.

Exclusions

No benefits will be paid for expenses incurred:

  1. For any portion of a charge for any service in excess of the Scheduled Benefit shown in the Schedule of Dental Services.
  2. For any procedure not listed as a Scheduled Benefit in the Schedule of Dental Services.
  3. For overdentures and associated procedures.
  4. For cosmetic procedures, including charges for porcelain or other veneer crowns, pontics, and porcelain or other veneer facings on crowns or pontics to replace molars.
  5. For the replacement of full and partial dentures, bridges, inlays, on-lays or crowns that can be repaired or restored to normal function.
  6. For implants; and for (a) the replacement of lost or stolen appliances; (b) the replacement of orthodontic retainers; (c) athletic mouthguard; (d) precision or semi-precision attachments; (e) denture duplication; or (f) sealants, except as specifically provided in the Schedule of Dental Services.
  7. For oral hygiene instructions; and for (a) plaque control; (b) the completion of a claim form; (c) acid etch; (d) broken appointments; (e) prescription or take-home flouride; or (f) diagnostic photographs.
  8. For services and procedures that are begun, but not completed by the end of the month in which coverage terminates.
  9. For charges in connection with an orthodontic service, except as specifically provided by the group policy.
  10. For charges incurred for treatment which would be given free of charge if you were not insured.
  11. For charges incurred for treatment which results from a war or an act of war.
  12. For care and treatment of a condition for which you are entitled to and eligible for benefits under any Worker's Compensation Act or similar law.
  13. For charges that are applied toward satisfaction of a Deductible, if any.
  14. For services that are not approved by the Council of Dental Therapeutics of the American Dental Association.
  15. For charges incurred for treatment which results from intentionally self-inflicted injury.
  16. For charges incurred for treatment which is given by a person's spouse or his or his spouse's father, mother, son, daughter, brother or sister.
  17. For charges incurred for treatment which is given by a person's employer or an employee of such employer.
  18. For charges incurred for treatment which is given after a person’s insurance ends, regardless of when the injury or sickness occurred.
  19. For charges incurred for treatment which is not essential for the necessary care or treatment of the injury or sickness involved.
  20. For services that are not recommended, approved and certified as necessary and reasonable by a dentist.

All person who were previously insured for dental insurance under this plan and later voluntarily end insurance will not be eligible to re-enroll for a period of two years following the date insurance was voluntarily ended.

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Answers about the plan, including eligibility, options, enrollment, customer service and more.

To print an enrollment form, click the "Enrollment Form & Brochure" button (according to the state you reside) for detailed plan information and plan provisions, including costs, exclusions, limitations and terms of coverage.

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 are able to choose between three premium payment options, whichever one best suits your needs:

  • Option 1: Auto Pay - Pay through Automatic Monthly Check Withdrawal (EFT Option). This saves you the time spent writing checks and remembering due dates.
  • Option 2: Credit Card - Pay your first quarter payment with a credit card online and quarterly payments will automatically be billed to your credit account.
  • Option 3: Bill Me Later - Pay through direct billing on a quarterly basis.

If applicable, an additional $2.00 billing fee will be included on your billing notice payable to the administrator. To save the fee, select Electronic Funds Transfer (EFT) as a safe and secure payment option.

Rates will not be changed unless they are changed for all insureds within your classification.

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. A lifetime maximum benefit of $850 applies to orthodontic benefits for insured dependent children under age 19.
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.
You will have 30 days from the date of receipt to review the Certificate of Insurance. If you are not satisfied with the terms of the certificate, simply return it to the Insurance Administrator and any premiums paid will be refunded in full.
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. For orthodontic coverage, there is a 12-month waiting period for insured dependent children under age 19.
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 when they are no longer eligible as your dependent.
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?"
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.

We're here to help! Please contact us in whatever manner is most convenient for you.

Administered by:

Mercer Consumer
12421 Meredith Drive
Urbandale , IA 50398

Phone: 1-800-882-5541

(Mon-Fri 7:30 a.m. to 5:00 p.m. and Sat-Sun 8:00 a.m. to 5:00 p.m., Central)

Email: afsa.service@mercer.com

Underwritten by:

United States Life
3600 Route 66
P.O. Box 1580
Neptune, NJ 07754

Website: http://www.personal-plans.com/product/aigamericangeneral
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