Page 8 - Hussmann- Chino Union OE Guide 2015 Plan Year
P. 8
Annual
Enrollment
Dental Dental
We partner with Delta Dental of Missouri (DDMO) to offer you
Find a Provider comprehensive dental insurance. While we cover a high level overview
To ind out if your dentist participates of your dental beneits in this guide, please refer to the full beneit
in the Delta Dental Premier summary available via the Hussmann Intranet by going to: HR
network, visit their website at Links>Human Resources>Total Rewards>Healthcare Beneits for
www.deltadentalmo.com.
frequency, age, and other limitations.
Click on Subscribers
You may visit the dentist of your choice and select any dentist on a
Then select “Find a Participating
Dentist” treatment by treatment basis. It is important to remember your out-
of-pocket costs may vary depending on your choice. You have two
For the Product Selection, click the options.
“Delta Dental Premier” box
1. In-Network: Delta Dental Premier Network. Delta Dental’s
Premier network consists of dentists who have agreed to accept
payment based on the applicable Premier Maximum Plan
Allowance and to abide by Delta Dental policies. This network
offers you cost control and claim iling beneits.
2. Out-of-Network: Non Participating Dentist. If you go to a non-
participating dentist (not contracted with Delta Dental plan for
the Premier network), DDMO will make payment directly to you
based on the applicable Maximum Plan Allowance for the non-
participating dentist. It will be your obligation to make full payment
to the dentist and ile your own claim. Claim forms can be obtained
online at www.DeltaDentalMO.com
Advantages of Selecting Participating Dentists
X All participating dentists have the necessary forms needed to
submit your claim.
X Delta Dental Premier participating dentists usually ile your claims
for you and DDMO will pay them directly for your covered
services.
X You are not responsible for paying the Premier participating
dentist any amount which exceeds the applicable Maximum Plan
Allowance. You are only responsible for any non-covered charges,
deductible, and coinsurance amounts.
8
Enrollment
Dental Dental
We partner with Delta Dental of Missouri (DDMO) to offer you
Find a Provider comprehensive dental insurance. While we cover a high level overview
To ind out if your dentist participates of your dental beneits in this guide, please refer to the full beneit
in the Delta Dental Premier summary available via the Hussmann Intranet by going to: HR
network, visit their website at Links>Human Resources>Total Rewards>Healthcare Beneits for
www.deltadentalmo.com.
frequency, age, and other limitations.
Click on Subscribers
You may visit the dentist of your choice and select any dentist on a
Then select “Find a Participating
Dentist” treatment by treatment basis. It is important to remember your out-
of-pocket costs may vary depending on your choice. You have two
For the Product Selection, click the options.
“Delta Dental Premier” box
1. In-Network: Delta Dental Premier Network. Delta Dental’s
Premier network consists of dentists who have agreed to accept
payment based on the applicable Premier Maximum Plan
Allowance and to abide by Delta Dental policies. This network
offers you cost control and claim iling beneits.
2. Out-of-Network: Non Participating Dentist. If you go to a non-
participating dentist (not contracted with Delta Dental plan for
the Premier network), DDMO will make payment directly to you
based on the applicable Maximum Plan Allowance for the non-
participating dentist. It will be your obligation to make full payment
to the dentist and ile your own claim. Claim forms can be obtained
online at www.DeltaDentalMO.com
Advantages of Selecting Participating Dentists
X All participating dentists have the necessary forms needed to
submit your claim.
X Delta Dental Premier participating dentists usually ile your claims
for you and DDMO will pay them directly for your covered
services.
X You are not responsible for paying the Premier participating
dentist any amount which exceeds the applicable Maximum Plan
Allowance. You are only responsible for any non-covered charges,
deductible, and coinsurance amounts.
8
