Smile 365

 

 

FCL Dental Takeover Benefit/Credit for Prior Coverage

FCL is extending the takeover benefits to new Smile 365 dental members that had prior coverage with a previous dental carrier. These members may qualify to receive credit for the months that they’ve had coverage and may go towards their 12-month waiting period for Type 3-Major Services.

Below are the criteria that will need to be met to be considered for credit of prior coverage.

The prior coverage must be a PPO/MAC or DHMO plan

The member will need to obtain a letter/certificate from the previous carrier with the following information:

*Carrier Name- [outline of dental plan] 100/80/50

*Effective Date of Coverage [Coverage Dates]

*Family Coverage for:

*Self: Member Name, SSN & DOB

*Spouse: Name DOB

*Child(ren): Name DOB

 

The letter must be on carrier letterhead and state the type of coverage (include annual maximum and coinsurance), list the names of all covered members and there must be a start date and end date for the coverage.

Proof will not be accepted from the following:

*Bank draft

*Screen shot

*Word document

*There cannot be more than a 30-day break in coverage for the takeover benefits to be extended to the member

*Any discount dental plans

 

Once documentation has been submitted allow 72 business hours for review. All proof of prior coverage is subject to carrier approval.