FLE x Plans Members choose what they Value Most
FLE x Plans Members choose what they value most; better coverage or more provider choice Renaissance Dental Your Partner in Success! As a leading dental benefits provider, the Renaissance Family of Companies takes great pride in being an established expert within the private exchange marketplace. Our relationships with leading nationwide exchanges are a vital component to the success of our enterprise. We believe our industry-leading experience with individual dental plans, extensive provider networks and commitment to serving our customer makes us the ideal choice for purchasing dental coverage. Our innovative plan designs, cutting-edge technology and nationwide networks combine to offer some of the finest dental plans available. What are FLEX Plans? Renaissance provides a diverse portfolio of Flex Plan options so that customers get the best choice and value. Our plans include options for traditional coverage, as well as low cost options that cover preventive services, to ensure that every customer can find a plan that s right for them. Renaissance Dental Experience That Matters At Renaissance Dental, it is our goal to bring quality to all we do by providing flexible, innovative plans and exceptional customer service. We are proud of our "A" rating from A.M. Best Company and lead the industry with our online AllAccess portals that make it easy to access and manage information. Our more than 55 years of experience in dental claims processing within the Renaissance Family of Companies has taught us how to innovate, improve operating efficiency and manage costs. We pass the benefits of our experience along to our clients in the form of savings. Renaissance Dental is part of the Renaissance Family of Companies that collectively provides dental coverage for more than 13.1 million people paying out nearly $3 billion for dental care annually. 1 Setting the Standard for Service Excellence Our dedication to customer satisfaction is evidenced through our call center representatives and their willingness to exceed customer expectations. We answer all calls in an average of 15 seconds and resolve 99 percent of all calls on first contact. We process over 96% of written inquiries in 10 days or less. In addition, we have the ability to process all claims in 10 days or less with an accuracy of 99.3 percent. 1 (1)2014, Renaissance Internal Data
Nationwide Dental Solutions Renaissance Dental provides immediate access to individual dental products with more than 200,000 credentialed dental access points. 1 PPO Network Partners: We offer nationwide access to our proprietary network of dentists in addition to other national and regional PPO networks for maximum choice and value. This type of seamless integration to best-in-class nationwide PPO networks combined with our state-of-the-art claims processing system provides a complete solution that no other carrier can match. The Renaissance Difference At Renaissance, we know the value of building lasting relationships. That s why we work hard to deliver a personal, FLEXible experience to all of our customers. Renaissance sets the bar higher with solutions that provide: Industry-leading claims processing Expert customer service Detailed reporting features Flexible benefits and plan designs National dental networks Note: Stratose was formally Coalition America. Includes 4Most Dental Network in West Virginia.
Flex Plan A: Excellent coverage and the least out-of-pocket costs, especially when selecting the PPO Flex Plus plan. No waiting periods on preventive or basic services Low deductible that is waived for diagnostic, preventive or orthodontic services Generous $1,500 annual maximum Coverage for implants and orthodontic Flex Plus vs. Flex Basic: Network: Savings: FLEX Plus: PPO MAC Over 200,000 nationwide PPO providers. 1 Out-of-network payments based on PPO network rates Lowest out-of-pocket costs when seeing a participating network dentist Coverage: 100/100/60 100/80/50 Dental Benefit Highlights Diagnostic and Preventive Services FLEX Basic: PPO Visit any dentists nationwide Out-of-network payments based on 90 th percentile UCR FLEXibility to see any dentist with great savings in-or out-of-network FLEX Plus FLEX Basic Diagnostic and preventive services includes exams, cleanings, fluoride and space maintainers 100% 100% Brush Biopsy to detect oral cancer 100% 100% Radiographs X-rays 100% 100% Sealants to prevent decay of permanent molars 100% 100% Basic Services Emergency palliative treatment to temporarily relieve pain 100% 80% Periodontic services to treat gum disease 100% 80% Endodontic services root canals 100% 80% Oral surgery services extractions and dental surgery 100% 80% Minor restorative services fillings 100% 80% Other basic services miscellaneous services 100% 80% Major services (12 month waiting period) Relines and repairs to bridges, implants and dentures 60% 50% Major restorative services crowns 60% 50% Prosthodontic services bridges, implants and dentures 60% 50% Orthodontics (Up to age 19) Orthodontic services braces 50% 50% Maximums Policy year maximum payment applies to diagnostic and preventive, basic and major services Lifetime maximum orthodontics Annual deductible Policy year deductible (enrollee/family maximum) applies to all services except diagnostic and preventive and orthodontics Allowed Amounts $1,500/person $1,500/person $50/$150 $50/$150 Allowed amount in-network providers PPO Fee PPO Fee Allowed amount out-of-network providers PPO Fee 90 th percentile (1)2014, Renaissance Internal Data.
Flex Plan B: Generous plan options with traditional coverage that is affordable while encouraging regular visits to your dentist. No waiting periods on preventive or basic services Low deductible that is waived for diagnostic, preventive or orthodontic services $1,250 annual maximum Coverage for implants and orthodontic Flex Plus vs. Flex Basic: Network: Savings: FLEX Plus: PPO MAC Over 200,000 nationwide PPO providers. 1 Out-of-network payments based on PPO network rates Lowest out-of-pocket costs when seeing a participating network dentist Coverage: 100/80/50 100/60/40 Dental Benefit Highlights Diagnostic and Preventive Services FLEX Basic: PPO Visit any dentists nationwide Out-of-network payments based on 90 th percentile UCR FLEXibility to see any dentist with great savings in-or out-of-network FLEX Plus FLEX Basic Diagnostic and preventive services includes exams, cleanings, fluoride and space maintainers 100% 100% Brush Biopsy to detect oral cancer 100% 100% Radiographs X-rays 100% 100% Sealants to prevent decay of permanent molars 100% 100% Basic Services Emergency palliative treatment to temporarily relieve pain 80% 60% Periodontic services to treat gum disease 80% 60% Endodontic services root canals 80% 60% Oral surgery services extractions and dental surgery 80% 60% Minor restorative services fillings 80% 60% Other basic services miscellaneous services 80% 60% Major services (12 month waiting period) Relines and repairs to bridges, implants and dentures 50% 40% Major restorative services crowns 50% 40% Prosthodontic services bridges, implants and dentures 50% 40% Orthodontics (Up to age 19) Orthodontic services braces 50% 50% Maximums Policy year maximum payment applies to diagnostic and preventive, basic and major services Lifetime maximum orthodontics Annual deductible Policy year deductible (enrollee/family maximum) applies to all services except diagnostic and preventive and orthodontics Allowed Amounts $1,250/person $1,250/person $50/$150 $50/$150 Allowed amount in-network providers PPO Fee PPO Fee Allowed amount out-of-network providers PPO Fee 90 th percentile (1)2014, Renaissance Internal Data.
Flex Plan C: Extremely affordable plan option for basic and minor restorative services, like fillings covers over 80% of submitted procedures performed in a dental office. 1 100 percent coverage for exams and cleanings Low deductible that is waived for diagnostic and preventive No waiting periods Flex Plus vs. Flex Basic: Network: Savings: FLEX Plus: PPO MAC Over 200,000 nationwide PPO providers. 1 Out-of-network payments based on PPO network rates Lowest out-of-pocket costs when seeing a participating network dentist Coverage: 100/80/0 100/50/0 Dental Benefit Highlights Diagnostic and Preventive Services FLEX Basic: PPO Visit any dentists nationwide Out-of-network payments based on 90 th percentile UCR FLEXibility to see any dentist with great savings in-or out-of-network FLEX Plus FLEX Basic Diagnostic and preventive services includes exams, cleanings, fluoride and space maintainers 100% 100% Brush Biopsy to detect oral cancer 100% 100% Radiographs X-rays 100% 100% Sealants to prevent decay of permanent molars 100% 100% Basic Services Emergency palliative treatment to temporarily relieve pain 80% 50% Periodontic maintenance cleanings by specialist 80% 50% Simple extractions non-surgical removal of teeth 80% 50% Minor restorative services fillings 80% 50% Other basic services miscellaneous services 80% 50% Major services Relines and repairs to bridges, implants and dentures 0% 0% Major restorative services crowns 0% 0% Prosthodontic services bridges, implants and dentures 0% 0% Maximums Policy year maximum payment applies to diagnostic and preventive, basic and major services Annual deductible Policy year deductible (enrollee/family maximum) applies to all services except diagnostic and preventive and orthodontics Allowed Amounts $1,000/person $50/$150 $50/$150 In-network providers PPO Fee PPO Fee Out-of-network providers PPO Fee 90 th percentile (1)2014, Renaissance Internal Data
Don't see what you need? Check Out Plan D! Renaissance gives you the FLEXibilty to have dental coverage without breaking your budget. Plan D is our PPO MAC coverage option that will give you peace of mind so you'll never have to worry about having a healthy smile. No waiting periods on preventive or basic services Low $50 deductible that is waived for diagnostic and preventative services Great coverage in- or out-of-network More than 200,000 nationwide PPO providers 1 PPO MAC: 80/50/50 Lowest out-of-pocket costs when seeing a participating network dentist Out-of-network payments based on PPO network rates Dental Benefit Highlights Diagnostic and Preventive Services In-Network Out-of-Network Diagnostic and preventive services includes exams, cleanings, fluoride and space maintainers 80% 80% Brush Biopsy to detect oral cancer 80% 80% Radiographs X-rays 80% 80% Sealants to prevent decay of permanent molars 80% 80% Basic Services Emergency palliative treatment to temporarily relieve pain 50% 50% Periodontic maintenance cleanings by a specialist 50% 50% Simple extractions non-surgical removal of teeth 50% 50% Minor restorative services fillings 50% 50% Other basic services miscellaneous services 50% 50% Major services (12 month waiting period) All other periodontic services to treat gum disease 50% 50% Endodontic services root canals 50% 50% All other oral surgery services complex extractions and dental surgery 50% 50% Relines and repairs to bridges, implants and dentures 50% 40% Major restorative services crowns 50% 40% Prosthodontic services bridges, implants and dentures 50% 40% Maximums Policy year maximum payment applies to diagnostic and preventive, basic and major services Annual deductible Policy year deductible (enrollee/family maximum) applies to all services except diagnostic and preventive and orthodontics Allowed Amounts $750/person $50/$150 $50/$150 In- or out-of-network providers PPO Fee PPO Fee (1)2014, Renaissance Internal Data.
Rating Assumptions and Requirements Eligibility is based on a minimum of 2 enrolled and maximum of 100. Plans with orthodontic coverage must have a minimum of 10 enrolled. Minimum enrollment required: 50 percent of eligible employees If less than 75 percent of your employees are located in the selected rating area, these rates are not valid. Rates do not include any applicable state claims taxes. The rates are valid only for the effective date noted above and are guaranteed for a 1-year non-retention contract. Self-billing is not allowed and you agree to pay as invoiced each month. Standard subscriber materials will be provided to you to distribute to your members. These include the Summary of Dental Plan Benefits, Certificate and reference cards. Printed dentist directories are not included. You can find participating dentists on our website at www.renaissancedental.com. The plan specifications are subject to Renaissance standard exclusions and limitations, including: No pre-existing condition exclusions or limitations. Oral exams and prophylaxes (cleanings) are payable twice per calendar year. Fluoride treatments are payable twice per calendar year up to age 14. Bitewing X-rays are payable once per calendar year and full mouth X-rays are payable once in any 5-year period. Sealants are payable once per tooth per lifetime for the occlusal surface of first permanent molars up to age 9 and second permanent molars up to age 14. Crowns, bridges, dentures and implants are payable once per tooth per 5-year period. People with specific at-risk health conditions may be eligible for additional prophylaxes (cleanings) or fluoride treatment. The patient should talk with his or her dentist about treatment. Children under age 26 may be eligible for benefits, including children who are married, who do not live with the subscriber, who are not dependents for Federal income tax purposes and/or who are not permanently disabled. Eligbility and age limitations may vary by state. NOTES: This is a sample of benefits. Policies have exclusions and limitations that may limit coverage. For complete coverage details, please refer to your policy (D-100A-(state specific abbreviation, if applicable)). EXCLUSIONS: Charges or treatment for correction of congenital or developmental malformations or dentistry for aesthetic reasons; general anesthesia and/or intravenous sedation; cosmetic surgery (except reconstructive surgery for children because of congenital disease or anomaly); treatment by anyone other than a licensed dentist or dental hygienist; veneers, services related to temporomandibular disorders (TMD), prefabricated crowns as final restoration on permanent teeth and paste-type root canal fillings on permanent teeth; appliances, procedures and restorations for increasing vertical dimension, occlusion, tooth structure loss due to attrition, abrasion or erosion, or for periodontal splinting; orthodontic services; lost, missing or stolen appliances; services not in the Policy and/or Summary of Dental Plan Benefits. The premium rate will vary between plans. The policy has a term of one year and will automatically renew (upon payment of required premium) unless terminated in accordance with the policy provisions. Coverage may be terminated for reasons stated in the policy. Coverage ceases upon termination of the policy. Products and services referred to in this brochure may not be available in all states or jurisdictions. Underwritten by Renaissance Life & Health Insurance Company of America, Indianapolis, IN, and in New York by Renaissance Health Insurance Company of New York, New York, NY. Both companies may be reached at PO Box 1596, Indianapolis, IN 46206. IMAGES: REN-D-460, REN-D-0681, REN-DV-1469 CC-0060 v1 Ren Dental FLEX PLANS 1/16