Learn more about Highlights, Eligibility, Plan Details and Coverage Limits and Rates.
FREQUENTLY ASKED QUESTIONS
How do these plans work?
The Group Basic Dental Insurance Plan and Group Enhanced Dental Insurance Plan provide benefits for diagnostic and preventive care as well as almost every form of specialty dental treatment. You may go to any dentist you wish.
Each plan pays benefits according to their Schedule of Dental Services. The Schedule of Dental Services identifies the maximum dollar amount allowable that you and your dependents receive when a procedure is performed, not to exceed the actual charges.
What is the difference between the two plans?
Both dental insurance plans work very similarly. The only differences are in the amount of benefits paid and the rates. The Group Enhanced Dental Insurance Plan costs more, but pays a higher benefit amount for dental procedures, and has a higher annual maximum limitation.
The Group Enhanced Dental Insurance Plan also offers the option of including or excluding orthodontics. If you selected the Group Enhanced plan without orthodontics you receive a reduced rate.
Are their annual maximums?
Under the Group Basic Dental Insurance Plan, you and your covered dependents are entitled to receive up to $1,000 each in benefits per calendar year after the deductible is satisfied.
Under the Group Enhanced Dental Insurance Plan, you and your covered dependents are entitled to receive up to $1,200 each in benefits per calendar year after the deductible is satisfied.
A lifetime maximum benefit of $850 applies to each plan for orthodontic services for insured dependent children under age 19.
Who is eligible?
AIChE members in good standing and eligible dependents may enroll for coverage. Eligible dependents include a lawful spouse and dependent children, typically under age 21 (age 25 if a full–time student). (Subject to state variations.)
All persons who were previously insured for dental insurance under this plan and later voluntarily ended insurance will not be eligible to re-enroll for a period of two years following the date insurance was voluntarily ended.
What are the deductibles?
For all services, a deductible of $50 per insured person is required per calendar year, up to $150 maximum per family unit. The deductible is applied against insurance covered, not billed charges.
What is the waiting period?
Preventive, diagnostic, restorative (except major) and adjunctive services are provided immediately. Endodontics and oral surgery services have a 6-month waiting period.
All other services have a 12-month waiting period. Once you have been enrolled under the plan for 12 consecutive months, you are eligible for services under restorative-major, periodontics, prosthetics-removable and fixed bridge.
For orthodontic services, there is a 12-month waiting period for insured dependent children under age 19.
How are claims handled?
You can request that the benefits be paid either directly to your dentist, or you can be reimbursed for the benefit.
When is my coverage effective?
Your coverage will be effective the first day of the month following receipt of your enrollment form and first premium. Some services are subject to a 6 or 12 month waiting period.
When does the coverage terminate?
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 dependents will also end when they are no longer eligible as your dependent.
How do I enroll?
Once you have chosen between the Group Basic Dental Insurance Plan and the Group Enhanced Dental Insurance Plan, print out the appropriate enrollment form in the right margin of this page, fill it out and return it with your first premium payment (Check payable to Affinity Insurance Services, Inc.) to:
AIChE Insurance Program Administrator
159 E. County Line Road
Hatboro, PA 19040
What if I have second thoughts after I apply?
When you become insured, you will be sent a Certificate of Insurance detailing the provisions of this Plan. You will have 30 days from the date of receipt to review the Certificate of Insurance. If you are not satisfied with the terms of the certificate, simply return it to the Insurance Program Administrator and any premiums paid will be refunded in full.