REALTORS® DENTAL INSURANCE – FREQUENTLY ASKED QUESTIONS
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- Why should I buy a REALTORS® Dental Insurance plan through NAR?
- Where are REALTORS® Dental Insurance plans available?
- How do I qualify (eligible) for REALTORS® Dental Insurance?
- Who is an eligible dependent on REALTORS® Dental Insurance?
- If I had dental coverage through another plan or will be losing coverage soon, can the waiting periods be waived?
- If I have dental coverage through my spouse or another plan, does your plan coordinate benefits?
- How do I make changes to my REALTORS® Dental Insurance plan?
- When does REALTORS® Dental Insurance coverage begin?
- When does REALTORS® Dental Insurance coverage end?
- Will I receive an ID card for my REALTORS® Dental Insurance?
- What does MCE mean?
- Is Orthodontia available with REALTORS® Dental Insurance?
- Is Anesthesia covered under the REALTORS® Dental Insurance plans?
- Do I have to use a PPO dentist to receive benefits?
- How does REALTORS® Dental Insurance handle pre-existing conditions and work in progress?
- Do the REALTORS® Dental Insurance plans include any waiting periods before benefits are available?
- What happens if I apply for this insurance and then change my mind and decide that this policy does not fit my needs?
- What are the customer service telephone numbers and hours of operation for the REALTORS® Dental Insurance claims department?
- How do I cancel my REALTORS® Dental Insurance coverage?
Why should I buy a REALTORS® Dental Insurance plan through NAR?
Many self-employed find it difficult to buy individual dental insurance. And if a plan can be found, the pricing for an individual plan can be very expensive. REALTORS® Insurance Marketplace is proud to offer REALTORS® Dental Insurance, an group dental plan offered exclusively to REALTORS® that brings members a choice of affordable plan options. We encourage members to review the four plan choices to consider which plan best fits their budget and dental care needs.
Where are REALTORS® Dental Insurance plans available?
How do I qualify (eligible) for REALTORS® Dental Insurance?
- be over age 18, unless a dependent of a member - There is no age limit to qualify for these plans
- be an NAR member
Who is an eligible dependent on REALTORS® Dental Insurance?
- an Insured's spouse.
- each unmarried child less than 26 years of age, (less than 30 years of age for discharged military dependents), for whom the Insured or the insured's spouse, is legally responsible, including:
- natural born children;
- adopted children, eligible from the date of placement for adoption;
- a grandchild that is a dependent of, and under interim court-ordered custody of the Insured;
- children covered under a Qualified Medical Child Support Order as defined by applicable Federal and State laws.
- each unmarried child age 26 or older who:
- because of a handicapped condition that occurred before attainment of the limiting age, is incapable of self-sustaining employment; and
- is dependent on his or her parents or other care providers for lifetime care and supervision.
If I had dental coverage through another plan or will be losing coverage soon, can the waiting periods be waived?
Yes. If you have had coverage within two months of enrolling in one of the NAR dental plans, the six month waiting period on Type 3 procedures and the 12 month waiting period on orthodontic benefits can be waived. When enrolling, you will need to indicate that prior dental coverage existed for you and/or your covered dependents. An ID card or EOB from the prior dental plan can be included to verify prior coverage and allow us to authorize the waiver of the waiting periods.
If I have dental coverage through my spouse or another plan, does your plan coordinate benefits?
Yes. If you have coverage other another group dental plan, Ameritas will coordinate the benefits between the two plans. If you are covered as a dependent under a spouse's plan, the NAR plan would be considered "Primary" for you as the NAR member, and "Secondary" under your spouses plan. Your spouse would be considered "Primary" under their own coverage and"Secondary" under your NAR plan. Note: by coordinating benefits, the benefit between the two plans would equal no more than 100% of the total cost of the service.
How do I make changes to my REALTORS® Dental Insurance plan?
For customer service, billing, and plan change questions please contact our customer service department at 1-800-279-2290. Our office hours are M-F 8:30 to 5:00 central/standard time.
When does REALTORS® Dental Insurance coverage begin?
Coverage becomes effective next day (12:01 am) following the date the completed enrollment form is received and approved, or a specified date in the future (not more than 30 days in advance), provided that full premium for the coverage has been received.
When does REALTORS® Dental Insurance coverage end?
An insured Member's coverage ends when the Member is no longer eligible (as defined above), premiums are discontinued (subject to the grace period), when the policy terminates, or when the Member is no longer in good standing with the association, whichever occurs first. Coverage on a dependent ends on the earliest date they no longer meet the definition of an eligible dependent or on the date the Primary Member's coverage terminates, whichever occurs first.
Will I receive an ID card for my REALTORS® Dental Insurance?
The ID cards and policy are mailed out to your residence, typically within 3 days via USPS. You should receive the policy and ID cards within two weeks. If your provider does not accept the insurance you may obtain a claim form and submit the claims directly to Ameritas for processing.
What does MCE mean?
Maximum Covered Expense (MCE): a simple, easy to understand benefit at a very affordable rate. Members know exactly what the plan pays for each covered procedure, and they pay the difference between that amount and the dentist fees. The MCE increases based on the plan you select. The Value Plan has the lowest MCE and Platinum Plan offers the highest level. Additional out of pocket savings occur when a member uses an Ameritas Preferred provider.
Is Orthodontia available with REALTORS® Dental Insurance?
Yes. Under the Platinum, Gold and Silver plans, orthodontic benefits are available for children. Benefits are payable for orthodontic programs that were started before the dependent's 17th birthday. The Platinum, Gold and Silver plans provide a $1,000 lifetime maximum benefit per eligible dependent child.
Is Anesthesia covered under the REALTORS® Dental Insurance plans?
Yes. Anesthesia is covered under the Platinum, Gold and Silver plans.
Do I have to use a PPO dentist to receive benefits?
No. All members and their covered dependents have the freedom to choose any licensed dental provider. The PPO providers available to you have agreed to negotiated fees, so out-of-pocket costs for the member are often much lower than using a non-participating provider. As an added comfort, all PPO dentists have passed an extensive screening to ensure not only a saving to the plan but high quality care. Not every dentist is able to meet Ameritas' standards. Only those who adhere to Ameritas' credentialing and quality assurance requirements are able to join and remain in the network. This process includes:
- State insurance department verification to confirm that dentists are licensed, and to uncover whether any disciplinary action has ever been filed
- Review of malpractice insurance and that no malpractice suits have been filed
- Legal department and dental consultant review of any license disciplinary action or discovery of malpractice suits.
- Certification of adherence to quality assurance guidelines as mandated by state and federal entities, including OSHA and the Center for Disease Control.
How does REALTORS® Dental Insurance handle pre-existing conditions and work in progress?
The plan does not limit pre-existing conditions. Simply knowing a dental procedure is needed does not prohibit the plan from providing coverage. As long as the procedure is not incurred prior to the member's effective date of coverage, the procedure is eligible for benefits based on the plan coverage. Any procedures started prior to the member's effective date of coverage will not be eligible under the plan.
Do the REALTORS® Dental Insurance plans include any waiting periods before benefits are available?
Yes. On the Platinum, Gold and Silver plans, a six(6) month waiting period applies to all Type 3 Procedures before benefits are paid. A twelve (12) month waiting period applies to all Orthodontic Procedures before benefits are paid.
What happens if I apply for this insurance and then change my mind and decide that this policy does not fit my needs?
You have the right to review your policy within 10 days from the date you have applied. After you apply, you will automatically receive an email for you to review your application and certificate. If you do wish to terminate the coverage after you have reviewed the certificate, you will need to contact the customer service department by phone. We also require a written request with the policy holder's signature. If you have provided the correct information within the 10 day time frame, a refund of premiums, minus the administration fees will be issued and your policy will be deemed void, as though it had never been issued.
What are the customer service telephone numbers and hours of operation for the REALTORS® Dental Insurance claims department?
If you have any questions please call: Ameritas Group Claims Department at 800-487-5553 Representatives are available Monday - Thursday 7:00 am to 12:00 am (Central Standard Time) and Friday 7:00 am to 6:30 pm (Central Standard Time)
Visit the Ameritas website at: www.ameritasgroup.com
How do I cancel my REALTORS® Dental Insurance coverage?
Dental insurance policy cancellation procedure: We are confident that this dental plan is the best plan available of its kind. We do care about you and your health and it is our job to make sure that your have secured dental insurance that will benefit your needs. If you have not obtained other insurance and have questions about this plan and the benefits it can provide for you and your family, please contact our customer service department at 1-800-279-2290. If you are confident that this dental insurance is not going to give you the benefits you need and you have met your twelve month commitment, or you have obtained new group dental coverage, you can terminate this plan. In order to avoid any future payments to be drafted from your account. We do require a hand written signature no later than five days before the next scheduled draft date. If you are requesting to cancel your plan and are within your 10 day right to review period, your hand written request is required within ten days from the effective date requested on your application. If required information is received in a timely manner, a refund of your premiums paid minus any enrollment fees will be issued to the account on file. Scan and Email request with signature to: email@example.com or Fax # : 608-531-2707 or Mail request to: InsuranceTPA.com/SASid PO Box 998 Janesville WI 53547