Page 12 - Allegacy 2019 Benefit Guide Part Time

Helpful Dental Information

 Both dental options include one (1) additional cleaning or periodontal maintenance per 12 months, if member
is in 2 or 3 trimester of pregnancy.
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 See any dentist or maximize your benefits by utilizing Unum’s national network of more than 323,000 dentists
across the country. Please note that you are not required to use a Unum participating dentist for services;
however, if you do, you will have the advantage of automatic claims filing by the dental provider as well as
lower out of pocket cost due to network negotiated discounts. If you wish to review the participating dentist
provider listing, please visit www.unumdentalcare.com.

 If you decide to change dental plans at annual enrollment (i.e. move from Core to Buy Up or vice versa), you will
not be subject to coverage waiting periods. In addition, late entrant penalties do not apply if coverage is elected
when you are first eligible for coverage or during an annual enrollment period. If coverage is elected outside of
these two timeframes, Unum will apply a 12 month waiting period to Basic & Major services (as well as to
Orthodontia on the Buy Up Plan).

 You may manage your dental benefits online with AlwaysAssist (www.alwaysassist.com) and on-the-go with
the AlwaysAssist mobile app available in the Apple App Store as well as for Google play.

 The Core and Buy Up plans include Dental Carryover Benefit. Members who take care of their teeth, but use
only part of their annual maximum benfeit during a benefit period are rewarded with extra benefits in future
years! How does it work?
o If an insured member submits qualifying claims for covered expenses during a benefit year and, in that
benefit year, receives benefits that are less than the threshold limits outlined below for the insured’s
dental plan, the insured will be credited a carryover benefit.
o Carryover benefits will be accrued and stored in the insured’s carryover account to be used in the next
benefit year.
o The limits for each plan are outlined below:
 Core Plan Carryover Benefit Amount - $300
Annual Claims Threshold Limit - $600
Carryover Account Limit $1,200

 Buy Up Plan Carryover Benefit Amount - $400
Annual Claims Threshold Limit - $800
Carryover Account Limit $1,500

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