Employer Group Plan Design Changes Effective 1-1-19

December 17, 2018
  • Amarr Entrematic (Group #1498) - Diagnostic and Preventive changing to two (2) times per calendar year. Periodontal surgical re-entry frequency limit changing from 24 months to 36 months. Adding Preventive Plus*.
  • Axcet HR Solutions (Group #50064) - Adding posterior composite coverage.
  • Georgia Pacific (GP) (Group #53000, #53001, #53002) - Adding Preventive Plus* to group #'s 53000-0-1-0, 53000-0-2-0, 53000-0-3-0, 53000-0-4-0, 53001-0-1-0, 53001-0-2-0, 53001-0-36-0, 53001-0-37-0. Adding adult orthodontics to Flex Ortho only (53000-0-3-0, 53000-0-4-0). Changing orthodontic age to 26 on ALL GP groups that include orthodontic coverage.
  • Koch Industries (Group #50950) - Adding Preventive Plus* (excludes group #50951).
  • Stormont Vail Healthcare (Group #91504) - Adding adult and child orthodontics with $1,000 separate orthodontic maximum. Adding deductible of $50/person up to $150/family (was previously no deductible).
  • YRC (Group #90305, #90405, #90505, #90705, #92305, #92405, #92505, #92605) - Adding Incentive Plan (Benefits will increase from the base level to the incentive level if the member receives a routine exam and/or cleaning at least one (1) time in twelve (12) months. Benefits will increase to the incentive level ninety (90) days after a cleaning and/or exam. Benefits for new members will begin at the incentive level. After twelve (12) months, benefit levels will be determined by the date of the last Diagnostic or Preventive treatment).

*Preventive Plus - Diagnostic & Preventive services do not accumulate to Annual Maximum.

Please be aware plan changes may occur at the beginning of a plan year. Plan rollovers occur throughout the month of December for the new year, to verify current year accruals contact Customer Service at 800.234.3375.

As a best practice, we recommend that you verify patient coverage and benefits each time your patient seeks treatment at your office. You can easily check by logging in to your dentist account.

**New group Announcement** - Pfizer employees will be covered under the Delta Dental PPO plan through Delta Dental of New York effective January 1, 2019. Delta Dental of New York’s contact center is happy to answer any questions about this transition. Please feel free to call 888-893-4411.