sun life dental fee schedule

Prepaid dental products are provided and administered by SLOC, and are provided by prepaid dental companies, affiliated with SLOC, in certain states except New York. December 19, 2022 2023 Dental Fee Guides Every year, provincial and territorial dental associations release their annual fee guides. 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. Sun Life Dental Secure Choice Dental Plans Affordable, convenient dental care that will really make you smile. United Concordia Inc. . Schedule B Indemnity plan People First Plan Code #4084 - Humana It is a dental network plan that arranges for provision of covered dental services through a contracted network of private practice dentists. Fraud alert! 865 North Arizola Road Casa Grande, AZ - 85122 How do patients find out that I am a participating dentist? All rights reserved. Kansas City, MO 64179-0155, FAX: 855-303-3908 Please contact your Sun Life Group Benefits representative. PO Box 2940 A complete array of group dental programs, including: Active and Passive PPO plans. Who do I contact if I have questions regarding my responsibilities with your PPO Networks? A pre-estimate is recommended on all services over $500. Can I send electronic attachments? Schedule B Indemnity plan People First Plan Code #4084 Schedule of benefits TYPE I - PREVENTIVE DENTAL SERVICES D0120 1Periodic oral examinationestablished patient $23 D0140 Limited oral evaluationproblem focused1. Representatives are available to assist you Monday through Thursday 7:00 a.m. to 7:00 p.m. CT and on Friday from 7:00 a.m. to 5:30 p.m. CT. How do I refer my patient to a specialist? The Sun Life name and logo are trademarks of Sun Life Assurance Company of Canada. A. To enroll for your dental plan, please call People First at866-663-4735or enroll online. 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? Please call Client Services at800-443-2995. JavaScript is required to use content on this page. Plus, each plan includes plenty of extra benefits such as teeth whitening and bonding, along with: Sign up today. NEWS and INFO. Visit us atwww.sunlife.com/us. This resource is designed exclusively for HUSKY Health members and includes information that can impact your oral . 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. Additionally a claim must be submitted to the plan for reimbursement. We will send you a roster each month listing the members who have selected your facility as well as the plan they have purchased. We dont ask for payment or deposit as part of our recruitment process. Members who werein the adult dental pilot are eligible under the adult dental expansion. Provincial dental fee increases for 2020 - Sun Life Nationwide counts are state level totals. Are there fees assessed for payments by Virtual Credit Card? 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 are multiple ways to find a dentist. Sun Life and the globe symbol are trademarks of Sun Life Assurance Company of Canada. * - (*$19 in IL, TN.) How do I verify patient eligibility? A DentalSave fee schedule is a list representing the maximum charges participating providers can charge plan members for services. Claims should be submitted to the address on the back of the patient's ID card. (English / Espaol). Our Client Services number is 800-442-7742. | Website Terms and Conditions | Designed by Sagapixel. If I have a problem with a claim from you, which number do I call? (English / Espaol). Your roster will list all the members that have selected your practice along with the plans that they have purchased. Plus, you get plenty of extra benefits such as teeth whitening and bonding, along with: Sign up today. Administrative Services Only plans. DENTAL Prepaid Plan - 2023 How the plan works You pay reduced fees called "copayments" for dental services provided by a network provider (Plan Dentist). To initiate a fee guide change, you need to contact your Account Executive. The full increase in cost will show in the plan's experience and will impact the next renewal or their first ASO bill of 2021. 2022 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. Rocky Mountain Health Maintenance Organization, Inc. UnitedHealthcare Insurance Company of the River Valley. Affordable Dental Costs and Flexible Financing Options. As part of your welcome notification, you were provided a copy of your Participating Dentist Agreement and your Personal Fee Profile. All eligible members will receive an identification card listing their PPO network. To receive information and forms to join our Prepaid Plan, call Provider Relations at 800-434-2638 or emailPrepaidDental@sunlife.com. The Sun Life name and logo are trademarks of Sun Life Assurance Company of Canada. 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. In certain states prepaid dental products are provided by prepaid dental companies affiliated with SLOC. Option 1: Search by your Group ID Group ID Where can I find my Group ID? How do I join the Prepaid Plan? We offer the Sun Life Dental Network and Sun Life Focus Network . Login - Dental Health Alliance, L.L.C. Even if your network fee would otherwise apply, in the event that your usual fee is lower than the network fee, you may not bill the difference between your usual fee and the network fee. We will never ask for money as part of the application process: Were aware of fraudulent job postings and offers of employment posted on social media, job boards and messaging apps. Limitations and Exclusions Celebrating 25. years of smiles. Visit us at www.sunlife.com/us. What happens if the procedure I performed is not listed on the Copayment Schedule? 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). Our PPO networks include dentists contracted with Dental Health Alliance, L.L.C. (DHA) and dentists under access arrangements with other dental networks. 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). They can make this request immediately, or upon renewal. E.T., to speak with a live Customer Service Representative. We wont change a plan sponsors premium rates on January 1, 2021 to recognize these higher increases. 5 Averages based on 2022 Q2 Sun Life internal data. Claim forms must be filed, and certain limitations and exclusions apply. $25.68. Clinton, IA, 52733-29400, Email questions or comments to: Discount applies to select full dentures or implant prosthetics only and not to related dentistry services, if any. If I have a dispute with you, how can it get resolved? For the dental care you need at a price you can afford, choose the Secure Choice Dental Plan that is right for you. The Secure Choice Plan is provided by UDC Dental California, Inc. Prepaid dental products are provided by Sun Life Assurance Company of Canada (SLOC) (Wellesley Hills, MA), under Form Series BDC-GDSA. All rights reserved. Michael Pink, DDS is a consulting dentist for Sun Life. Dental insurance | Sun Life U.S. Sun Life Retiree Dental Insurance - PEF Membership Benefits Program Feel free to co-brand the flyer by adding your logo or practice name in the upper right corner. What states are the Prepaid Dental Plans available in? . Username: Password: The program addresses areas of credentialing, utilization reviews, professional standards, the monitoring and resolution of member complaints and appeals, and the assessment of the satisfaction of our providers and eligible members through surveys and evaluations. In that case, well continue to pay dental claims in alignment with the fee guide in their contract. Here are some options available to them. Contact the benefits administrator at the phone number on the patient's dental ID card. We use the data in these guides to determine the maximum reimbursement amounts for dental services. Plan benefits for specialty care vary by plan. Some group health plans restrict coverage for dental conditions that are present . DENTAL Indemnity PPO Plan - 2021 Coverage includes dental benefits through payroll deduction. Find A Dentist - Sun Life, US Its the only way a candidate can apply to a role at Sun Life. Dental Plan Benefits & Limitations | American Dental Association - ADA Please contact Client Services at800-443-2995, Monday through Thursday from 7:00 a.m. to 7:00 p.m. CT and Friday from 7:00 a.m. to 5:30 p.m. to request a copy of the most current Copayment Schedules. Additionally a claim must be . OR Coverage is available to retirees through COBRA and to COBRA participants if they were enrolled prior to termination. No referral is necessary. Well continue to reimburse plan members based on the fee guide indicated in their plan. PO Box 419596 Hours of operation are 7 a.m. - 5:30 p.m. CT. Sun Life Dental Transamerica - National PPO Which partners lease the Dental Benefit Providers of California, Inc. network? PPO plan | Sun Life U.S. For dentists and dental offices - Sun Life How does Sun Life handle services performed by teledentistry? For dental providers who want to participate in the Maryland Healthy Smiles Dental Program as an individual provider or group practice, complete a Medicaid provider application at ePREP.health.maryland.gov . How do I find out about coverage, deductibles, co-pays and maximums for your patients? Enroll now 2022 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. PDF DENTAL Introducing your State of Florida Prepaid Plan - Prepaid 225 2023 The Connecticut Dental Health Partnership. At the time of enrollment, you must choose a Plan Dentist for eachfamily member from the list of participating general dentists. To have someone contact you about Sun Life Dental, please complete the form below. How do I join your PPO networks? What is the Prepaid Dental Plan? 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). What are the guidelines for submitting pre-estimates? Indemnity w/ PPO (4084) Type I: Preventative Services (Routine cleanings, X-rays, etc.) Provider search allows dental plan members to easily locate participating network dentists and vision providers. 15% discount on endodontic procedures and 25% discount on all other specialty procedures. Prepaid dental products are provided by Sun Life Assurance Company of Canada (Wellesley Hills, MA), under Form Series BDC-IDSA. We will never ask for money as part of the application process: Were aware of fraudulent job postings and offers of employment posted on social media, job boards and messaging apps. 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. This plan is underwritten by Sun Life Assurance Company of Canada (Wellesley Hills, MA). Simply download the flyer and attach to email or print and mail. Please contact National Electronic Attachment (NEA) for specifics at 770-441-3203, Fax 770-441-3204 or visitwww.nea-fast.com. 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. The credentialing process is based on standards developed by the National Committee for Quality Assurance (NCQA) and our provider network. Supplemental Health benefits can close coverage gaps and ease medical plan decision making, Million dollar claim cost drivers and legislative updates, Leave and accommodation compliance Fall 2019, COVID-19 Response: Employment Compliance Considerations for Re-opening the Workplace, How the CARES Acts loan programs could protect your Business Employees and Benefits, Compliance Issues Related to COVID-19 Vaccine Mandates by Employers, Get to know Sun Lifes new Client onboarding experience, 2022 High-cost claims and injectable drug trends analysis, Current healthcare challenges and impacts on the future of care, The growing role of digital innovation in insurance, An introduction to help meet your COVID-19 vaccine and testing needs, Employer compliance challenges regarding COVID-19 vaccine mandates and testing, Updates and answers to your questions on COVID-19 vaccines and more, What employers need to know about federal infrastructure negotiations and vaccine mandates, Compliance 2021 mid-year update: Key leave, accommodation and COVID developments, 2021 High-cost claims and injectable drug trends analysis, ComPsych Webinar: Support in an Uncertain World, Bundling dental and vision to help employees build their diabetes health care team, 2022 Year in Review Compliance Update Webinar, Caring for our members means more than protecting their income, FMLA Leave Administration Tuneup: Employer Choices Worth Reviewing, How Do You Manage Mental Health Conversations To Ensure Compliance, 2023 High-cost claims and injectable drug trends analysis. FAMILY PLAN FEES. 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. Provider services - Sun Life Whats important to know is that some of these increases are higher than what weve seen in the past. 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. Who do I call with questions about my network participation? Additionally a request must . Please contact Client Services at the number indicated on the patient's ID card or you can utilize one of our self-service options. 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*) Here are some examples of fee guide changes available to plan sponsors: If your Client chooses one of the approaches in Option 2, we advise them to send a communication explaining any changes to their plan members. Option 2 If you have plan sponsors that prefer to ensure that the increases to their costs are more limited, they can initiate a fee guide change. 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. For non-covered services, whether the fees are listed in your Personal Fee Profile apply depends on (i) whether you have elected to offer your network fees on non-covered services and (ii) in some cases, any applicable state law. Maximum Allowable Charge plans. Box 2940 Whichever plan you choose, the low monthly rate and out-of-pocket costs will give you many reasons to smile. If you have a question about your monthly roster or the eligibility of a specific patient, please contact Client Services at800-443-2995. If you have a question about the plans listed or need copies of the Copayment Schedules, please contact Clients Services at800-443-2995. 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. In all states except New York, prepaid dental products are provided and administered by Sun Life Assurance Company of Canada (SLOC) (Wellesley Hills, MA). We work hard to make care and benefits easy for our member. Dental Provider Portal: Product offerings may not be available in all states and may vary depending on state laws and regulations. If services not listed on the Copayment Schedule are necessary, you may bill the patient at your normal retail charge. All rights reserved. PDF State of Florida DENTAL The Sun Life name and logo are registered trademarks of Sun Life Assurance Company of Canada. All rights reserved. Sun Lifes approach to 2021 Dental Fee Guides, Building a musculoskeletal health strategy, Forms for businesses with under 50 employees, Forms for businesses with over 50 employees, Group Benefits for small and medium businesses, Group Benefits for small and medium businesses overview, Supporting you and your employees on your health journey, Qubec: increase of 4.2% overall (compared to 2.6% in 2020), Ontario: increase of 4.6% overall (compared to 1.27% in 2020), Alberta: no change (compared to 4.4% in 2020). Members select a Plan Participating Facility from our directory at the time of enrollment. Whichever plan you choose, the low monthly rate and out-of-pocket costs will give you many reasons to smile. The full increase in cost will show in the plans experience and will impact the next renewal or their first ASO bill of 2021. These include preexisting conditions, annual maximums, and managed care cost containment measures. How do I sign up for electronic claims? Please review all of the options available to determine the best one for you. For a list of the underwriting entities go to our Legal Notice. Please contact Client Services at800-443-2995and provide us with the name of the specialist you would like for us to contact. The member should call Client Services to request assignment to your facility. $293.15, once annually. Heres how you canprotect yourselfand what to do if yoususpect fraud. Our fax line for pre-estimates is 563-242-0184. (PPACA). . Your practice information is included in our directory of participating providers and on our website. Please consult your plan materials or call Client Services at800-443-2995for assistance. Typical Dental Plan Benefits and Limitations. All our roles are posted on ourWorkday career site. Blue Shield of California - dental health maintenance organization (DHMO) Blue Shield of California - dental preferred provider organization (DPPO) Health Net of California - DHMO Health Net of California - DPPO All general dentists and specialists must be credentialed before being accepted as a participating provider. A pre-estimate is not required but encouraged in order to avoid any confusion about the amount of plan benefits that would be paid. 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. All dentists and specialists must be credentialed before being accepted as a participating provider. .$31 D0145 Oral evaluation for a patient under three years of age and counseling with primary To receive information and forms to join our PPO networks, call Provider Relations at 800-434-2638, emailppoinforequests@sunlife.comor complete this online form. Sun Life Some prepaid plans, (DHMO series plans), include a third payment based upon the services provided. Learn about the federal COVID-19 legislation updates and the state of the 2020 presidential election. Provincial dental fee increases for 2022 It's that time of year when most provincial and territorial dental associations release their annual fee guides. Enroll now Supplemental Health benefits can close coverage gaps and ease medical plan decision making, Million dollar claim cost drivers and legislative updates, Leave and accommodation compliance Fall 2019, COVID-19 Response: Employment Compliance Considerations for Re-opening the Workplace, How the CARES Acts loan programs could protect your Business Employees and Benefits, Compliance Issues Related to COVID-19 Vaccine Mandates by Employers, Get to know Sun Lifes new Client onboarding experience, 2022 High-cost claims and injectable drug trends analysis, Current healthcare challenges and impacts on the future of care, The growing role of digital innovation in insurance, An introduction to help meet your COVID-19 vaccine and testing needs, Employer compliance challenges regarding COVID-19 vaccine mandates and testing, Updates and answers to your questions on COVID-19 vaccines and more, What employers need to know about federal infrastructure negotiations and vaccine mandates, Compliance 2021 mid-year update: Key leave, accommodation and COVID developments, 2021 High-cost claims and injectable drug trends analysis, ComPsych Webinar: Support in an Uncertain World, Bundling dental and vision to help employees build their diabetes health care team, 2022 Year in Review Compliance Update Webinar, Caring for our members means more than protecting their income, FMLA Leave Administration Tuneup: Employer Choices Worth Reviewing, How Do You Manage Mental Health Conversations To Ensure Compliance, 2023 High-cost claims and injectable drug trends analysis. Maryland Healthy Smiles Dental Program for Providers Did you know that more than 75% of American adults suffer from various forms of gum disease and dont even know it? Please be cautious. Slo haga clic en TRANSLATE en la barra azul de arriba, 2023 The Connecticut Dental Health Partnership. Affordable dental care you can feel good about. We adhere to quality standards encompassing a broad range of care and service issues that are the cornerstone of our Quality Assurance Program (QAP). To locate a participating dentist in your area, click PPO Dental on this page under Provider Search to complete the search. The patient's responsibility is the difference paid by us and the fee for the service actually performed. Select Your Fee Schedule | DentalSave Dental Plans Sun Life /Grievance Department Our PPO dentists are allowed to bill the patient for services performed that are not covered by the plan. Questions? Learn about the federal COVID-19 legislation updates and the state of the 2020 presidential election. This resource is designed exclusively for HUSKY Health members and includes information that can impact your oral health and overall health and well-being. No referrals or authorization is needed for the prepaid plans. Claims should be submitted with your usual fees, not the network fee listed in your personal fee profile. 1The Sun Life Focus Dental Network is only available for policies issued in North Carolina. All rights reserved. You will receive monthly capitation payments for these members and you will collect copayments from the members based on the copayment schedule. How do I know which plans I accept? For assistance, call the Provider Enrollment Helpline at 1-844-4MD.PROV (1-844-463-7768) or email MDProviderRelations@automated-health.com . The dental services listed in the following schedule are covered when provided by the Member's selected Plan Dentist. All rights reserved. For assistance, call the Provider Enrollment Helpline at 1-844-4MD.PROV(1-844-463-7768)or emailMDProviderRelations@automated-health.com. Plus, each plan includes plenty of extra . Connection Dental Network Payor List In New York, group insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Lansing, MI) under Policy Form Series 15-GP-01 and 16-DEN-C-01. You may contact Change Healthcare or Tesia. Fee guide of current year minus X% - for example, a plan sponsor could choose to cover the 2021 fee guide minus 2%. We currently offer dental plans in the following states. Except in very limited circumstances, there are no claim forms to submit. PPO using your Connection Dental Fee Schedule. 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. How do I know if I have the most current version of the plan Copayment Schedule(s)? Typically, there's an increase in costs across the board. The State of Florida offers you comprehensive dental coverage through an array of dental plans. The Sun Life name and logo are registered trademarks of Sun Life Assurance Company of Canada. Sun Life has dental Sun Life and the globe symbol are trademarks of Sun Life Assurance Company of Canada. Prepaid dental products are provided by UDC Dental California, Inc., an affiliate of Sun Life Assurance Company of Canada (Wellesley Hills, MA), under Form Series UDC-CA-IDSA. No, please verify whether or not the patient has the SBA before treatment. Get in today for a limited-time deal on dentures and implant dentures. We encourage you to refer to this information for any questions you may have. The member pays any applicable copayment(s) at the time of treatment according to the Copayment Schedule. 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). Can I file claims for the difference in copayments and costs? Ready to learn more about Sun Life Dental? Product offerings may not be available in all states and may vary depending on state laws and regulations. Limitations and Exclusions 7:00 AM - 5:30 PM CST Keep communicating with your patients Sun Life is sponsoring a "What to expect at your next dentist visit-during covid-19" flyer that you can send to your patients. All Rights Reserved. If Member requires dental specialty services that cannot be provided by selected Plan Dentist, Member may obtain from a Plan Specialty Dentist the services marked as dental specialty services (S) in this Section 1.

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