

Frequently Asked Questions
The following are several questions commonly asked by our members
regarding their benefits. We hope that these answers will help you get the
most out of your dental benefits.
ENHANCED PPO DENTAL PLAN
1. What is my deductible?
Your deductible will vary depending on whether or not you choose to use a participating PPO Provider. When using the in-network PPO dentist you will have a $25 calendar year deductible (maximum $75 per family). When using the out-of-network dentist you will have a $50 calendar year deductible (maximum $150 per family.
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2. What is my maximum benefit?
The maximum annual payment is $2,000.
3. Who submits my claim - me or my dentist?
It is your responsibility to ensure that claims
are filed. However, some dental offices will be happy to assist you with
filing a claim.
4. Who gets paid - me or my dentist?
You will want to discuss this with your dentist
before he or she provides services. Reimbursement will be determined by
"assigning" benefits at the time your claim form is completed.
Your dentist may want you to pay him or her
directly, and then you would be reimbursed, or your dentist may prefer the
insurance company pay your claim directly to the dentist.
5. How are benefits coordinated if I am covered
under more than one policy?
If you have coverage with two insurance
companies, you may want to file a claim with both companies. One company
will be considered "primary" and thus will pay benefits first. The
other company will be considered "secondary" and
will pay its benefits only after the "primary" company has done so. The
total of the benefits paid by the two companies will not exceed your
actual costs.
6. How do I obtain a claim form?
Some dental offices may have claim forms, some
may not. If neither your dental office nor your Insurance Benefits office
has claim forms, CompBenefits will be happy to supply you with one.
Please call 1-866-890-4464 and 954-527-4088.
7. How long do I have to file a claim?
All claims are to be filed within one (1) year of
the date of service.
8. Can I go to any dentist?
Your policy allows you to visit the dentist of
your choice. Remember, you will receive enhanced benefits when utilizing a
PPO Participating Provider. Please refer to your Schedule
of Benefits for more details.
9. Is there orthodontic coverage on my plan?
Yes. The Enhanced PPO Dental Plan offers orthodontic benefits for adults and children. Please refer to the Schedule of Benefits for details.
If you have questions about any of the four
plans . . .
Please call CompBenefits' Customer Care at 1-866-890-4464 or 954-527-4088.
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