Dental

Opening the door to benefits...

TotalBen currently offers TotalBen offers all forms of insurance, including Dental Insurance.

Both group and individual plans are available.

To quote a group dental plan, complete the following two items and submit them to info@totalben.com . Groups of any size can be written, provided it is based on a business; even a husband-wife business.

For Groups of 2+

If you are not a business owner or are looking for coverage just for yourself and/or family, TotalBen offers three options.

For Individuals:

  • Primestar Dental + Vision Option - where you can enroll online and choose from a range of plans, with just in-network or also out-of-network (see the provider of your choice) benefits

  • Spirit Dental + Vision Option - where you can enroll online and choose from a range of plans, with just in-network or also out-of-network (see the provider of your choice) benefits

  • Dental DMO - where you are only covered seeing a provider in the network
  • Dental PPO - where you can see any provider, either in or out of the network

What Makes a "Better" Plan

Dentist of your Choice

Does your plan allow you to see the provider of your choice, even one that does not accept any form of insurance?

Reimbursement: UCR vs MAC

Does your plan reimburse based on Usual, Customary and Reasonable ("UCR") charges or does it utilize a Maximum Allowable Charge ("MAC"), leaving you responsible for any difference?

Name of Network

The name of your carrier is not what you mention when searching for in-network providers. You need to know the name of the network and any associated sub-type.

Late Entrant vs Annual Open Enrollment

If you do not enroll when the plan is initially offered, can you enroll on the anniversary date without having to satisfy any waiting periods first?

Premium Penalty for Extra Children

Does your premium increase if either you, or the total group average, exceed a pre-determined limit on the number of children per family?

Deductible on Preventative

Many plans have a deductible on Basic and Major services. Does your policy also have a deductible on Preventative care? Perhaps just on out-of-network Preventative care?

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Waiting Period for Basic/Major

For initially eligible enrollees, is there a waiting period for Basic or Major services, before you can receive benefits?

Active or Passive PPO

Does your PPO offer a lower percentage of benefit when going out-of-network? In other words, does it ACTIVELY encourage you to stay in-network by offering a higher benefit? Or, do the percentages stay the same (PASSIVE)?

Pre-existing Waived

If you need care prior to enrolling, will the policy cover you for that pre-existing condition?

Exclusions (like missing tooth)

Most plans have exclusions. Find out what your policy excludes, and for how long. The most common exclusion is known as a Missing Tooth Exclusion.

Root Canals: Basic or Major

How does your plan classify a root canal? Is it under Basic or Major services? What about other endo/perio treatments?

Ortho Benefit Look-back

If you have an Orthodontia benefit, does it reduce your eligible benefit by amounts a prior carrier may have paid (known as a look-back)?