FAQ: Dual Dental Coverage and Coordinating Benefits

March 6, 2019

What is Dual Dental Coverage?

Dual dental coverage means you have more than one dental plan. This could be another Dental Select plan, or another insurance company. Dental Select will work to coordinate benefits on your behalf.

 

What is Coordination of Benefits?

Coordination of Benefits (COB) is when you, the member, is enrolled on more than one dental plan. Rather than duplicating or over insuring benefits, we will coordinate benefits with your other carrier on your behalf to maximize your savings on dental costs. One plan is considered your primary carrier and the other will be considered the secondary.

 

How is COB information collected?

If you are covered by two different dental carriers, please let us or your dental office know. COB information can be collected when submitting claims or contacting us to set up coordination of benefits. We will need any pertinent information that may include: spouse name, social security number and the contact information of the other insurance carrier.

 

How soon is information updated?

Once the information is entered, COB information is updated automatically and changes will be reflected within 48 to 72 hours.

 

How is COB paid?

Dental Select automatically calculates by the system and is administered the same whether it is in-network or out-of-network, it is automatically processed if we receive all of the information. If you are the employee or policyholder on the plan, then this is typically the primary plan that pays first. However, there is also the “birthday rule”, that will also determine which spouses plan pays primary. Claims will be processed for any dependents on both plans based on which parents plan is primary. A claim processed for a dependent only on one plan will use only that plan.

When we do not have COB information for dependents and the claim is submitted against the DS plan but the competitor plan is primary, the DS plan will ultimately be denied and the other plan will process first. However, the EE will be primary on their own plan and the claim will process where no COB is necessary. COB is mostly important when dependents are involved.

 

If additional COB information is required for claim payments, a notice is sent to both you and dentist requesting information.

 

How can I check the status of a claim or view an EOB?

Your current benefits, claims and EOBs are available for to view anytime through the web portal.

 

Need to check the status of a claim? Login here.