is eligible for this coverage?
plan is offered to individuals and their spouse age 18+
and their unmarried dependent children (from
birth to age 19 or 25 if a full-time student - subject
to state requirements). All persons
listed on the Application for Coverage must reside
at the same home address.
plan of dental insurance is NOT currently available
to residents of: CO,
Notice - "Any person who, with intent
to defraud or knowing that he or she is facilitating
a fraud against an insurer, submits an
application or files a claim containing a false or
deceptive statement may be guilty of insurance
does my coverage start?
starts on the effective date. The effective date
issued will begin on the 1st of the month (at
12:00am), following Co-ordinated Benefit Plans,
Inc.’s receipt of the completed Application for
Coverage form and payment of the first month plan
are my payment options?
can pay in monthly installments by credit card
(MasterCard or VISA) or auto bank withdrawal.
services are not covered?
following Services are not covered by the American
Health Shield – Voluntary Dental Insurance plan:
Services for injuries or conditions paid pursuant to
Workers Compensation or Employer’s Liability laws;
Services or appliances started prior to the covered
person’s effective date;
Treatment by other than a Dentist or licensed dental
Correction of congenital or developmental
malformations, cosmetic surgery or dentistry for
Medications and prescription drugs;
Services for the diagnosis or treatment of
temporomandibular (TMJ/TMD) disorders;
Lost, missing or stolen appliances of any type;
Pulp caps, maxillofacial prosthetics or
Services or supplies received as a result of dental
disease, defect or injury due to an act of war,
declared or undeclared; and
Charges related to hospitalization or general
anesthesia and/or intravenous sedation for
is not a complete listing of plan Exclusions. For a
complete listing, refer to the Policy or
is the Benefit Year Maximum?
maximum amount payable for all Covered Dental
Charges in any benefit year as shown in the Coverage
Schedule. The Benefit Year Maximum will apply to
each insured person.
Statement of Policy Provisions Relating to Premiums,
Renewability, and Termination
Policy is renewable at the option of the Master
Policyholder or the Insurer. Upon 31 days prior
written notice, the Insurer reserves the right to
change the premiums, subject to state specific
requirements. Coverage may be terminated
by the primary insured or the Insurance Company upon
31 days prior written notice to the other party, or
for other reasons stated in the Policy or Certificate.