Learn more about Highlights, Eligibility, Coverage Limits and Rates and Frequently Asked Questions.
Two Plans to Choose From
The AIChE Group Basic Dental Insurance Plan and Group Enhanced Dental Insurance Plan are both very similar. Their eligibility requirements and plan details are identical.
Where they differ is in the benefits paid and the rates. Quite simply, you can elect to pay a little more for the Group Enhanced plan and you receive a higher fee schedule for dental services rendered.
A good way to decide which plan is right for you and your family is by examining the Coverage Limits & Rates page and by comparing the fee schedules for each plan:
Group Basic Dental Insurance Plan: Schedule of Dental Services
Group Enhanced Dental Insurance Plan: Schedule of Dental Services
How the Plans Work
The Group Basic Dental and Group Enhanced Dental plans each:
- Provide benefits for diagnostic and preventive care as well as most forms of specialty dental treatment.
- Allow you to see any dentist you wish.
- Identify the maximum allowable benefit for each dental procedure on their Schedule of Dental Services. The dollar amount assigned to each procedure is the maximum you receive, not to exceed actual charges.
- Reimburse you for procedures performed, or you can request that the benefits be paid directly to your dentist.
Freedom to Use Your Own Dentist
With many employer-provided or other types of dental plans, you are required to use a network or participating dentists or seek referrals for specialty treatment. With the Group Basic Dental and Group Enhanced Dental plans, you are free to choose your own dentist or specialist.
Comprehensive Benefits
The Group Basic Dental and Group Enhanced Dental plans provide comprehensive insurance coverage for more than 155 different dental services, including diagnostic, preventive and specialty dental treatments like endodontics, periodontics, oral surgery, prosthetics and orthodontics.
Benefits Paid to You or Your Dentist
Under your dental coverage, you can request the benefits be paid either directly to your dentist, or you can be reimbursed for the benefit.
SmileMax® Dental Network
The Group Basic Dental and Group Enhanced Dental plans include an optional PPO feature through the SmileMax® Dental Network. The SmileMax® network:
- can help reduce your out-of-pocket expenses,
- is made up of dental professionals at more than 140,000 locations nationwide,
- contracts to provide dental services at negotiated fees,
- helps ensure quality care, because all network dentists are screened according to a rigorous credentialing process.
Members are encouraged to explore the SmileMax® network as you will be charged pre-arranged fees that are guaranteed to be at or under the dentist's usual fee. According to the national average, you'll save between 20% and 40% when using a network dentist.
To find a SmileMax® dentist:
If your dentist does not currently participate in the SmileMax® Dental Network, you can contact the program administrator to obtain a nomination form to nominate him/her for membership.
Effective Date
Your coverage will be effective the first day of the month following receipt of your enrollment form and first premium.
Please note that some services are subject to a 6 to 12 month waiting period (see the Waiting Period section on the Coverage Limitations and Rates page).
When Coverage Terminates
Your dental coverage will be terminated only if:
- you cease to be a member of the AIChE;
- you fail to pay the appropriate premium when due; or
- the group policy is discontinued.
Coverage for your dependent spouse and children, if enrolling, will be terminated if:
- your insurance ends,
- dependents' insurance ends under the group policy,
- the person ceases to be a dependent, or
- the premium is not paid for the dependent when due.
Certificate of Insurance
When you become insured, you will be sent a Certificate of Insurance detailing the provisions of the plan under which you are insured.
Payment Options
Two payment modes are available to suit your needs and budget: Electronic Fund Transfer (EFT) and direct billing.
If you choose to have your premiums deducted electronically from your checking or savings account, you can select from monthly, quarterly, semiannual or annual EFT options. Bills sent to you directly can be mailed on a quarterly, semiannual or annual basis.
Premiums on the Rate page are shown monthly and quarterly. When paying semiannually multiply the monthly rate by 6, and when paying annually, multiply the monthly rate by 12. (There may be a slight difference in the premium due to rounding.)
Grace Period
Once you are accepted into the plan, you will have a 31-day grace period for your payment of renewal premiums.
Portable Coverage
Your dental coverage goes with you wherever you go—whether you travel or plan to move—as long as you remain an AIChE member and pay your premiums when due.
Exclusions
To keep your rates economical, there are some things the plans do not cover. No benefits will be paid for expenses incurred:
- For any portion of a charge for any service in excess of the Scheduled Benefit shown in the Schedule of Dental Services.
- For any procedure not listed as a Scheduled Benefit in the Schedule of Dental Services.
- For overdentures and associated procedures.
- For cosmetic procedures, including charges for porcelain or other veneer crowns, pontics, and porcelain or other veneer facings on crowns or pontics to replace molars.
- For the replacement of full and partial dentures, bridges, inlays, on-lays or crowns that can be repaired or restored to normal function.
- For implants; and for (a) the replacement of lost or stolen appliances; (b) the replacement of orthodontic retainers; (c) athletic mouthguard; (d) precision or semi-precision attachments; (e) denture duplication or; (f) sealants, except as specifically provided in the Schedule of Dental Services.
- For oral hygiene instructions; and for (a) plaque control; (b) the completion of a claim form; (c) acid etch; (d) broken appointments; (e) prescription or take-home flouride; or (f) diagnostic photographs.
- For services and procedures that are begun, but not completed by the end of the month in which coverage terminates.
- For charges in connection with an orthodontic service, except as specifically provided by the group policy.
- For charges incurred for treatment which would be given free of charge if you were not insured.
- For charges incurred for treatment which results from a war or an act of war.
- For care and treatment of a condition for which you are entitled to and eligible for benefits under any Worker's Compensation Act or similar law.
- For charges that are applied toward satisfaction of a Deductible, if any.
- For services that are not approved by the Council of Dental Therapeutics of the American Dental Association.
- For charges incurred for treatment which results from intentionally self-inflicted injury.
- For charges incurred for treatment which is given by a person's spouse or his or his spouse's father, mother, son, daughter, brother or sister.
- For charges incurred for treatment which is given by a person's employer or an employee of such employer.
- For charges incurred for treatment which is given after a person's insurance ends, regardless of when the injury or sickness occurred.
- For charges incurred for treatment which is not essential for the necessary care or treatment of the injury or sickness involved.
- For services that are not recommended, approved and certified as necessary and reasonable by a dentist.
This plan is underwritten by The United States Life Insurance Company in the City of New York, NAIC No.70106, domiciled in the State of New York with a principal place of business of 1 World Financial Center, 200 Liberty Street, New York, NY 10281. It is currently authorized to transact business in all states plus DC, except PR. This summary is a brief description of benefits only and is subject to the terms, conditions, exclusions and limitations of Group Policy Nos. V610406 and V610407. Coverage may vary or may not be available in all states.
The underwriting risks, financial and contractual obligations and support functions associated with the products issued by The Unites States Life Insurance Company in the City of New York (United States Life) are its responsibility.
AG - 8728