Dental Products - Lincoln Financial Group

Dental Products
GLM-01210NY 3/07
L i f e a n d A D & D L o n g - T e r m D i s a b i l i t y S h o r t - T e r m D i s a b i l i t y D e n t a l W o r k s i t e

Dental
Products
By packaging dental
coverage with other premier
insurance plans offered by
Lincoln Financial Group, you
can provide employees with
a comprehensive benefits
package at very affordable
rates.
Adding dental insurance to your benefits package can
help with employees’ overall health and increase loyalty.
Ultimately, this could impact your company’s bottom line.
Dental Plan Options TO SUIT YOUR NEEDS
Lincoln Financial Group offers a variety of dental plan options and features.
Traditional fee-for-service plans provide first-class benefits regardless of which
dentist is used. Or, PPO plans can help lower an employee’s out-of-pocket
expense by seeing a dentist in the PPO network. In addition, there is no
balance billing for employees who use a PPO dentist.
Lincoln Financial also offers scheduled benefit plans allowing employers to
provide more economical dental coverage. To encourage employees to take
advantage of routine dental services, this plan includes the option to cover up
to 100% of Usual and Customary charges.
Deductibles can range from $25 to $100 with a family maximum of two or
three times the individual deductible. Annual maximums range from $500 to
$2,500 with orthodontic maximums up to $2,500 (depending on the size of
the group).
With Lincoln Financial dental plans, employers select the coverage best suited
to fit the company’s and employees’ needs. Dental coverage is underwritten
by Lincoln Life & Annuity Company of New York, a Lincoln Financial Group
affiliate. These policies provide dental insurance only.
MORE CHOICES MEANS MORE AFFORDABLE
Along with a choice of plans, a choice of payment options
is also available. Employers can pick anything from
employer-pay-all to employee-pay-all and anything in
between. So even if budgets are tight, employers can
still offer a high quality dental program with a range of
employee contribution options.
True group plans are available to groups with a minimum
of 25% employer contribution toward the premium.
Or, voluntary plans allow employers to offer an easy to
administer benefit without bearing the full financial
burden. In turn, employees get a highly-valued benefit at
economical group rates. All through convenient payroll
deduction.

Covered Services
The types of services covered include: preventive and diagnostic; basic;
major; and orthodontic.
Preventive and diagnostic services include routine exams and cleanings,
x-rays and fluoride treatments. Basic services can include fillings and
extractions, oral surgery and anesthesia, while major services cover crowns,
bridges, and dentures.
Root canal therapy and treatment of gum disease (periodontics) can be
covered as either a basic or major service. Periodontal cleanings may be
covered up to four times a year, less any routine cleanings.
Orthodontic benefits can be provided for children only or the entire
family (subject to minimum participation requirements). For voluntary
groups, child orthodontics are always available. Lincoln Financial provides
orthodontic coverage for dependent children even if they are fitted for braces
after age 19, if full-time students.
SAVE TIME AND MONEY WITH ONLINE Services
As a proven industry leader for innovations in service and support,
Lincoln Financial offers real-time, online group administration to save
time, save money, and reduce errors.
From enrollments to claims to ordering ID cards and certificates, our
customers have online access to information in real time, 24 hours a day.
This helps avoid delays in adjustments, speed claims processing, and
eliminate errors in claims and billing.
“Routine oral health
exams can detect signs of
infection, systemic disease,
osteoporosis, and some
forms of cancer.”
Executive Summary (2000),
Oral Health in America:
Report of the Surgeon General
Dental providers benefit from our online services as well. We process claims
promptly and accurately with more than half of all claims auto-adjudicated
within 48 hours and over 99% handled within six working days.
“Fifty-one percent of employers
report Dental is the most
important insurance benefit
after Medical.”
Trends and Opportunities (2004),
A Look at the U.S. Group
Dental Market

FAX BACK SERVICE FOR FAST ANSWERS TO COVERAGE QUESTIONS
Lincoln Financial Fax Back reports provide dentists with virtually instantaneous
patient eligibility and benefit information. This helps expedite the eligibility process
so the dentist can attend to patients in a timely manner.
Dental offices simply call (800) 842-3729 and enter the employee’s Social Security
number. The information is faxed within minutes, arriving in a clear and concise
format to help eliminate misinformation regarding benefits. The documentation can
then be kept in the patient’s permanent file for future reference.
LOCATE PPO Dentists WITH EASE
The Lincoln Financial online PPO directory allows employees to search for dentists
within a specified radius of their home or office. They can also see if their current or
preferred dentist or specialist is part of the PPO network. And employers can generate
directories based on the specific needs of their group – by metropolitan area, by ZIP
code, or by county.
Participation REQUIREMENTS
Dental plans are issued to groups covering as few as 10 employees. True group
plans require 75% of eligible employees be enrolled and 60% of eligible dependents.
Voluntary participation may be as low as 25% for groups with more than 200 eligible
employees.
Exclusions and Limitations
The plan does not cover services started before coverage begins or after it ends. Services must be
necessary and appropriate for the claimant’s condition. Benefits are limited to services specifically
shown on the list of procedures included in the policy unless coverage for additional services is
required by state law. Benefits are not payable for duplication of services or for treatment by a
practitioner who is a member of the covered person’s immediate family.
Service Office Address:
8801 Indian Hills Drive
Omaha, NE 68114
800.423.2765
www.LFG.com
Home Office:
Syracuse, NY
Benefits are not payable for: placement of a prosthetic, unless needed to replace teeth extracted
while covered; the installation, maintenance, or removal of implants or any related expense; the cost
of athletic mouth guards, appliances to correct harmful habits, or the replacement of lost or stolen
dental appliances; services for treatment of TMJ or congenital malformities, except as required by law;
veneers, cosmetic procedures, or medications administered outside the dentist’s office; prescription
drugs, analgesia, sedation, hypnosis, or acupuncture administered for the purpose of alleviating anxiety
or apprehension; and nitrous oxide.
Plan benefits are not payable for a condition for which the claimant is paid benefits under Workers’
Compensation, Occupational Disease Law, or any similar law; a condition for which benefits are
required under any mandatory No Fault Automobile Insurance Law; or a condition attributed to
military service. Coverage is not available for dental conditions caused by act of war, self-inflicted
injury, being involved in an illegal occupation, attempt to commit a felony, or active participation in a
riot.
Except as provided by the policy’s prior insurance credit provision, if benefits for orthodontia are
included, the plan does not cover any treatment plan started before coverage begins or during the
benefit waiting period.
Group insurance products are issued and underwritten by Lincoln Life & Annuity Company of New
York, a Lincoln Financial Group company. Lincoln Financial Group is the marketing name for Lincoln
National Corporation and its affiliates.
© 2007 Lincoln National Corporation
For use in New York only.