Dutcher Insurance Agency,
Inc.
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Table of ContentsGeneral
Select Individual Dental Plan
Gold Series Group Dental Plan
For Agents
General Who is Dutcher Insurance?Dutcher Insurance is a third party administrator. We’ve developed dental plans which are underwritten by SafeHealth Life Insurance Company. Back to TopWhat kinds of plans do you offer?Currently we offer an Individual/Family dental plan called Select Individual Dental and a group dental plan called Gold Series Group Dental. Back to TopAre your dental plans part of a network like a PPO or HMO?No, we offer indemnity plans where you can make your own choice of any dentist in the state you live. Back to TopWhat is an indemnity plan?An indemnity plan is a type of health care insurance that generally does not restrict a patient's choice of doctors and medical institutions. It basically reimburses physicians for services performed. Such plans are contrasted with group health plans, which provide service benefits through group medical practice. Back to TopIn what states do you offer dental insurance?We currently offer dental insurance in California and Texas. Back to TopAm I covered if I travel outside of my state or residence?If you are traveling outside your state of residence and have an emergency, your coverage is limited to pain-relieving service only. Non-emergency visits to a dentist in a state other than the one in which you live are not covered. Back to TopIf I live in one state, can I see a dentist in another state?No, you must choose a dentist in your state of residence for your dental needs. The only exception is in the case of a dental emergency which is limited to pain-relieving service only. Back to TopIs there an age limit on your Select Individual or Gold Series Group dental plans?There is no age limit on any of our dental plans. Back to TopWhat dentists can I go to for services? Do you have a list of dentists I am allowed to see?You can choose any dentist in your state to see for services. We do not have a list of dentists to choose from nor do we recommend certain dentists for services. Back to TopWhat billing methods do you offer for premium payments?Select Individual Dental Plan – We accept a monthly premium payment via electronic funds
transfer right from your banking account. We also offer quarterly and semiannual
billing methods which require a $15 billing fee per invoice generated. Back to TopDo you accept credit cards for payment of premium?No, we do not accept credit cards for payment. At this time we only accept personal checks for payment or electronic funds transfer monthly payment for the Select Individual Dental Plan. Back to TopWhat is the $2 association fee I am paying for each month?The $2 monthly association fee is what funds the National Council of Independent Consumers (NCIC) which is a group association allowing Dutcher Insurance to provide low costs on premiums. As an insured with Dutcher, you are a member of this association and certain benefits are made available to you. Currently the association benefits include access to a prescription drug discount card and prepaid legal services at reduced rates. For further details on the association and its available services, click here. Back to TopSelect Individual Dental Plan After I sign up for your Select Individual dental plan, how long until my coverage becomes effective?Coverage always begins on the first of a month. If we receive your complete
enrollment form and fees by the third of any given month, your coverage will
begin on the first of that same month. Back to TopIf I sign up for the monthly payment automatic draft on my Select Individual plan, when will the premium draft from my checking account?After you have signed up for the monthly payment method and included your
first two month’s premium payment with your enrollment form, the third and
subsequent month’s premium will be drafted out of your checking account around
the 10th of the month preceding the next month’s coverage. Back to TopWhat kinds of fees are due when signing up for a Select Individual plan?When enrolling in the Select Individual plan under the monthly electronic funds transfer
method, your enrollment amount will include two months of premium plus two
months of the NCIC association fee of $2 each and a one-time $10 initial
enrollment fee. Back to TopGold Series Group Dental Plan What kinds of fees are due when signing up for a Gold Series Group dental plan?When enrolling in a group plan, we require the appropriate amount of premium for the first month, a monthly administration fee of $20, an association fee of $2 per employee and a one-time initial enrollment fee of $10 per employee (maximum of $100). Back to TopWhat forms are needed to sign up a group?An employer enrollment form and an employee enrollment form (for each employee to be added to the policy) is required to set up a group. Back to TopWhat is the minimum size allowed for a group?The minimum group size is two employees. A group must be a company or entity involved in some sort of business. Our underwriting guidelines require that a group consists of 100% of eligible employees and that premiums are paid for fully by the employer. In addition not more than 50% of a group can be related by blood or marriage. Back to TopWhat happens if a group is currently on a non-Dutcher dental plan that wants to switch to the Dutcher Gold Series Group plan? Do waiting periods apply and is there any takeover issues?A group may switch from its existing carrier to Dutcher’s Gold Series Group plan, however, the takeover provision will be implemented. This requires an additional 10% of premiums each month. Under the takeover provisions, the 12 month benefit waiting period for Type 3 Major Procedures may be waived for individuals insured as part of a group of 10 or more employees provided the individual’s coverage has been in force at least 12 consecutive months immediately prior to the effective date of the new policy. Back to TopScheduled Reimbursement Group Dental Plan How does this plan work?This plan has a benefit year maximum and yearly deductible. Your benefit year starts on the first of month that your company first enrolled in this plan. The Reimbursement Schedule lists the procedures that are covered under this plan and the amount you will be reimbursed for each one. To receive the reimbursement, you or your dentist will file a claim with Dutcher Insurance (see “How do I file a claim?” below). Your Schedule also includes Exclusions and Limitations. These are part of your plan and provide more detailed information about how often procedures are covered. Be sure to review them prior to your first appointment with your dentist. Back to TopDo I have to choose a dentist when I enroll? Can I see my current dentist?On this plan you may receive treatment from any licensed dentist - there is no pre-selection or network requirement. Back to TopHow do I file a claim?In most instances, your dental office staff will ask you to sign an "assignment" form that allows them to file the claim for you. Both you and your dentist will receive an Explanation of Benefits that details how the claim was paid. If your dentist prefers that you file the claim, complete a standard claim form found on this website under the Forms tab and submit it to: Dutcher Insurance Agency, Inc.
Check your Certificate of Insurance for complete instructions. Once enrolled, you will receive a Certificate of Insurance booklet. This booklet will give you all of the information you need to effectively access your benefits. Back to TopFor Agents How do I get appointed as an agent with you?Please contact Dutcher via our website at www.dutchernet.com, via phone or email at inforequest@dutchernet.com to request a broker kit. This includes an agreement and a Form W-9 to get you started. Once we receive this information and your first booked business with Dutcher, we will appoint you immediately and commissions will begin to be paid to you. Back to TopHow can I get brochures or enrollment forms to promote your dental plans?Please contact Dutcher via our website at www.dutchernet.com, via phone or email at inforequest@dutchernet.com to request marketing supplies. We have available on hand brochures and enrollment forms for each of our products to send to you. In addition, we can email you PDF files of these same forms. Back to TopRevised: 07/26/07.
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