When Stewart, Human Resources Director for a hotel management company, begins researching dental plans for their employees, he's impressed by TransSmile®'s provisions for check-ups, cleanings, x-rays, fillings, crowns, emergency treatment and more. A well-rounded benefits package that includes dental insurance makes their business an attractive option for the hospitality career seekers he knows will strengthen their workplace.

Employers can choose one of our customized products (Value, Advantage or Preferred) designed to help employees reduce out-of-pocket costs.

Standard Product Designs for Groups With 10 To 250 Eligible Lives

Base Benefits
Annual Maximum Allowance
Annual Deductible*
Coinsurance Diagnostic and Preventative Services
Basic Restorative Services
Major Restorative Services
Waiting Period (for Major Restorative Services only)
Rate Guarantee

* The Annual Deductible is waived for Diagnostic and Preventative Services.

Optional Child Orthodontia
(employer elected)
Deductible
Lifetime Maximum
Dependent Eligibility
Coinsurance
Waiting Period
Value
$ 500
$ 50
100%
80%
n/a
n/a
12 months

 

n/a

Advantage
$ 1,500
$ 50
100%
80%
50%
12 months
12 months
$0
$1,000
Children through age 23
50%
12 months
Preferred
2,000
$ 25
100%
50%
50%
6 months
12 months
$0
$1,500
Children through age 23
50%
12 months

Details for Service Types

Diagnostic and Preventative Benefits* Cleaning, routine periodic and specialty exams once in any six consecutive month period, including initial oral exam
Sealants once per tooth on permanent maxillary and mandibular first and second molars with no decay on the occlusal surface (for eligible children 14 years of age or under)
Topical application of fluoride (once in any 12 consecutive month period for eligible dependent children)
Bitewing X-rays (one set in any 12 consecutive month period)
Periapical X-rays (four in any 12 consecutive month period)
Basic Restorative Benefits* Palliative minor emergency treatment for the relief of pain as needed by the participant
Amalgam (silver) and composite/resin (white) fillings (composites are not a covered benefit on molars)
Space maintainers for prematurely lost teeth (for eligible dependent children 13 years of age or under)
Full-mouth X-rays (once in any five consecutive year period)
Simple extractions of erupted teeth (no cutting)
Major Restorative Benefits* Complete or Partial Denture Reline - chairside or laboratory procedure to improve the fit of the appliance to the tissue (gums)
Complete or Partial Denture Rebase - laboratory replacement of the acrylic base of the appliance
Repairs to Complete and Partial Denture
Crowns, inlays, onlays and veneers for treatment of visible decay and fractures of tooth structure when teeth can not be restored with amalgam or composite restoration including repairs
Prosthodontics, including procedures for construction of fixed bridges, partial or complete dentures, and repair of fixed bridges, or implants as an alternative to prosthodontics.
Endodontics - pulpal therapy and root canal filling
Oral surgery including pre- and post-operative care and surgical extractions
Surgical Periodontics - surgical procedures for the disease of the gums and bone supporting the teeth
Non-Surgical Periodontics - treatment for the disease of the gums and bone supporting the teeth
Periodontal maintenance (once in any six-month consecutive benefit period following active periodontal treatment)
Stainless steel crowns used as restoration to natural teeth for eligible dependent children 15 years of age and under when teeth cannot be restored with a filling material.

* State variations may apply.

Administration provided by Employer Plan Services, Inc.

Employer Plan Services, Inc. is responsible for all administrative elements of TransSmile®, including policy issue, premium billing and collection, customer service and claims. The company is based out of Houston, Texas. For claim inquiries and customer service, please contact Employer Plan Services, Inc. at 800-447-6588 located at 2180 North West Loop West, Suite 400, Houston, TX 77018.

Click Here to Download Complete Product Details

 

This is a brief summary of TransSmile® dental insurance. Policy Form Series CPDEN100 and CCDEN100. Forms and numbers may vary. Insurance may not be available in all jurisdictions. Limitations and exclusions apply. Refer to the policy, certificate and riders for complete details.

CLE01B-0115 | Administration provided by Employer Plan Services, Inc., Houston, Texas.