Hallmark Dental Plan (H-5)

Hallmark Dental Plan (H-5)
“We Make Quality Dental Care Affordable!”
www.dencap.com
Welcome to...
the Hallmark Dental Plan (H-5)
Maintaining your dental health is important for your overall health. DENCAP Dental Plans is
pleased to present our Hallmark Dental Plan which provides high benefits at a low cost. The Hallmark
Dental Plan is a voluntary dental benefit program offered through one’s employer, union or association.
WHAT IS THE HALLMARK DENTAL PLAN?
The Hallmark Dental Plan provides you with a complete set of dental benefits at a fixed rate and covers
all areas of dentistry to maintain excellent oral health. The Hallmark Dental Plan benefits include:
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$2500.00 Annual Maximum Benefit per member/ per year with Primary Care Dentistry
$800.00 Annual Specialty Care Maximum, independent from Primary Care Maximum
No Deductibles
No Waiting Periods
No charges for oral examinations, routine cleanings by your Primary Care Dentist
Orthodontia (Braces) Benefits
Large Provider Network of Dentists
(For a complete listing of covered procedures refer to the “Schedule of Benefits & Co-payments”.)
Hallmark Dental Plan
Minimum of 3 Employees
$2500 Primary Care
$800 Specialty Care
$800 Pedodontics - Lifetime Max
Type I - Preventive - 100%*
Type II - Basic - 60%*
Type III - Major - 50%*
Type IV - Orthodontics - 35% discount*
Specialty Care - 50%
* PERCENTAGES APPROXIMATE, Based on Member Co-payments as
Listed in Schedule of Benefits
A
How Do I Enroll?
Employer or administrator provides each employee with a provider directory listing and
enrollment application.
Employee reviews provider directory listing and selects a dental office location for dental
services. Employee completes the enrollment application and submits the application to
the employer or administrator.
Employer, administrator or agent completes the Group Enrollment Application.
MAIL THE GROUP ENROLLMENT APPLICATION, EMPLOYEE APPLICATIONS, and CHECK OR
MONEY ORDER FOR FIRST MONTH PREMIUM to: DENCAP Dental Plans, 45 E. Milwaukee,
Detroit, MI 48202. New enrollment materials must be received at DENCAP by the 25th day
of the month prior to the first month of coverage.
DENCAP will send ID cards and member information to the employees about their dental
coverage. DENCAP will send monthly statements to group employer or administrator.
About DENCAP Dental Plans
• Michigan based, established in 1984
• State of Michigan Licensed
• Zero Grievances since founding of company
• Excellent, Live and Local Customer Service
at 313-972-1400
• 24 Hour Emergency Dentist on Staff
Active MeMbers of:
• National Association of Dental Plans
(NADP) – Founding Member
• Michigan Association of Health Plans
(MAHP)
• Detroit Regional Chamber
of Commerce
www.Dencap.com
WHO ARE THE PARTICIPATING DENTISTS?
The enclosed DENCAP Provider Directory lists the dental locations within the DENCAP network. Participating
Primary Care Dentists are carefully screened and selected for their commitment to quality patient care.
CAN I CHANGE MY PRIMARY CARE DENTIST?
Yes. You may change from one Primary Care Dental Location to another by contacting a DENCAP Member Service
Representative at 313.972.1400 or 800.875.2400.
WHAT IF I HAVE A DENTAL EMERGENCY WHILE OUT OF THE AREA?
DENCAP Dental Plans will reimburse you 50% up to $50.00 for emergency treatment required to alleviate pain
outside of a 50-mile radius of your Primary Care Dental Center.
HOW DO I ACCESS SPECIALTY CARE?
There are times when Specialty Care is needed to perform certain complex dental procedures. When you need
specialty dental care, DENCAP will process your referral to a board certified Specialist. The Hallmark Plan maintains a separate high annual maximum just for specialty care. Specialty care includes:
ENDONDONTICS .................Root Canal Therapy
ORAL SURGERY....................Surgical Procedures
ORTHODONTICS..................Teeth Straightening
PEDODONTICS.....................Dentistry for Children
PERIODONTICS ....................Gum Disease Treatment
MiChigAN CouNtiEs sErvED by DENCAP ProviDErs: WAyNE, oAklAND, MACoMb,
gENEsEE, MoNroE, iNghAM, liviNgstoN, WAshtENAW, kENt
Find a dentist near you by using the Dentist Locator online at www.dencap.com or by
viewing the DENCAP Provider Directory.
Do you know someone who needs Individual Coverage?
For Individual Dental Plans,
visit
www.ibcchoicedental.com
or call
313-972-1400
for
information
DENCAP Dental Plans…313-972-1400
G5-1 Rev. 03/08