Members

Information for members with individual or family dental plan

In most cases, members are responsible for deductibles and coinsurance at the time services are performed.
If you met your deductible on another dental plan, you cannot receive credit toward this plan’s deductible.
With Gold or Gold Plus Vision, you may "roll over" a portion of your unused maximum benefit to the next year ($350) if you submit at least one claim during the year and your total claims do not exceed $500 for the year.

Stepchildren are eligible for coverage.
Single, dependent children are covered to age 26 as long as premiums are paid when due.

Members have a "grace period" of 31 days to pay a premium after it is due. However, if the payment is not received, the policy will be terminated on the date the premium was due.
For members who enrolled through the Health Insurance Marketplace and applied a portion of their Advance Premium Tax Credits (APTC) toward the payment of their premium, a grace period of three consecutive months will be granted for the payment of premiums after receipt of the first month’s premium.
If your policy cancels for non-payment of premium, it may be reinstated within 60 days if the premium is paid (certain rules may apply). To get your policy reinstated and pay your premium, call 1-800-238-8379. (Reinstatement policy does not apply to policies purchased through the Health Insurance Marketplace.)

Pediatric Minor and Major Restorative Services are not subject to waiting periods.
Adult members enrolled in Dental Silver will have the 6-month waiting period for Minor Restorative services. The waiting period will be waived if the follow criteria is met:
- The application is received within 30 days of the termination date of the member’s previous coverage; and
- No later than 30 days from the effective date of the new policy with Arkansas Blue Cross and Blue Shield, the member provides us with:
  - A copy of the member’s previous dental policy Certificate of Coverage which reflects the policy's effective and termination dates; and
  - A copy of the member’s previous policy's benefit schedule which reflects at least six months of coverage for Minor Restorative services.
Members enrolled in Dental Gold or Gold Plus Vision will have the 6-month waiting period for Minor and Major Restorative services waived if the follow criteria is met:
- The application is received within 30 days of the termination date of the member’s previous coverage; and
- No later than 30 days from the effective date of the new policy with Arkansas Blue Cross and Blue Shield, the member provides us with:
  - A copy of the member’s previous dental policy Certificate of Coverage which reflects the policy's effective and termination dates; and
  - A copy of the member’s previous policy's benefit schedule which reflects at least six months of coverage for Minor and/or Major Restorative services.

Monthly premiums can automatically be deducted from your bank account. Call 1-800-238-8379 for more information.
Orthodontic services are not covered.
If you visit a nonparticipating dentist and need to have your claim processed, please mail your claim form to:
Dental Claims Administrator
P.O. Box 69436
Harrisburg, PA 17106-9436