Dental
American Exchange offers dental insurance through Principal. The Principal dental plan includes preventive care at 100% (no deductible) and two cleanings per calendar year. The Dental plan also offers coverage for Basic care services at 80% (after a $50 deductible) and Major care services at 50% (after a $50 deductible). The dental plan has an annual benefit maximum of $2,000.
To reduce your out-of-pocket costs and prevent balance billing, you are encouraged to use in-network dentists. Visit https://www.principal.com/find-dentist to locate participating dentists. Please refer to the Benefits Summaries for complete details. If you have further questions or would like a customer service representative to assist you in finding an In Network provider, please contact Principal's Group Benefits Administration department at: (800) 843-1371.
Below is a brief summary of your annual deductible and co-insurance costs. Please refer to the complete Benefit Summaries for additional details.
| Principal Dental Coverage | Plan Benefits |
|---|---|
|
Deductible
|
$50 individual | $150 Family |
|
Type A - Preventive Services (Deductible Waived): Cleanings, Exam, and X-rays
|
Plan pays 100% |
|
Type B - Basic Services (After Deductible): Fillings, Oral Surgery, Periodontics, and more
|
Plan pays 80% after deductible |
|
Type C - Major Services (After Deductible): Crowns, Implants, Bridges, and more
|
Plan pays 50% after deductible |
|
Annual Maximum (per person)
|
$2,000 per person |
Important Notes
- Deductible (waived for preventive)
- Family deductible is 3 x per person deductible.
- Combined deductibles: deductibles for basic and major in-network and non-network services are combined.
- Combined annual maximums: calendar year maximums for preventive, basic and major services are combined.
- Members utilizing participating network dentists will enjoy discounted dental fees in addition to protection from balance billing for charges above the dentist’s maximum allowable charges. Members utilizing non-participating dentists will have the same benefits but may be subject to balance billing.
Claims Process
In-Network
- Participating network dentists file the claim and accept payment from Principal
- Employees should not need to pay at the time of service for participating providers
Out-of-Network
- For out-of-network dentists, if the dentist does not agree to file the claim as out-of-network with Principal, employee pays at the time of service and files a claim for reimbursement
- The plan reimburses at the Maximum Allowable Charge for the service. This means that if you utilize an out-of-network provider, you could be balance billed for the difference in amounts between the provider Billed Charges and the Maximum Allowable Charge for the service.
