UFCW 1518 Dental Plan

Transfer Coverage From Another Plan

If you had coverage under another dental plan provided by an employer who is contributing or who is eligible to contribute to this Plan, you and your dependents will be entitled to basic and major dental coverage for a period of four months from the date of transfer.

The 1,000 credited hours requirement will be waived and any dental expenses paid by the Plan during the initial four months will be reduced by any amount paid or payable under the previous plan. In the fifth month and thereafter, the 240 credited hours test will apply in determining your eligibility.

Similarly, you will be eligible for orthodontic coverage if you were eligible for orthodontic coverage under the previous plan. Any qualifying period under the previous plan will be counted in determining eligibility for orthodontic coverage under this Plan. Benefits paid by the previous plan will be deducted from the lifetime maximum benefits payable by this Plan.

Introduction

Eligibility

Identification Card

Eligible Dependents

Definition of Child

When Coverage Begins

When Coverage Ends

Special Extensions of Dental Benefits

Transfer Coverage From Another Plan

Adding and Deleting Dependents

Basic Restorative and Preventive Services

Major Services

Orthodontic Services

Services not Covered by the Plan

Emergency Dental Care Anywhere

How to Submit a Claim

Co-ordination of Benefits

Further Information / Contact Information