
Keeping your oral health in good condition is vital to your overall health. Group Dental Insurance helps with out-of-pocket costs due to dental procedures. The Gap Dental Plan is a great fit for families, people who want to get regular dental check-ups, or those that just want that extra layer of protection for some of their out-of-pocket costs due to diagnostic & preventive, basic or major dental services.

GROUP DENTAL INSURANCE |
Coverage is available to paid Members of the United Business Association after the effective date listed in your welcome letter following the receipt of the Membership application and the payment of the first month's dues to the United Business Association.
Insurance benefits are underwritten by Renaissance Life & Health Insurance Company of America, Indianapolis, IN and in New York by Renaissance Life & Health Insurance Company of New York, New York, NY. Both companies (“Renaissance”) can be reached at P.O. Box 1596, Indianapolis, IN 46206. There is no ownership affiliation between Renaissance and Gap Dental & Vision. For complete coverage details, please refer to the certificate of insurance.
MAXIMUM BENEFITS
Annual Deductible: Individual / Family (Deductible waived for Diagnostic & Preventive Services) |
$50.00 / $150.00 |
Annual Maximum Plus Maximum Carryover1 |
$1,000.00 |
1 If at least one covered service is paid in a benefit year and the total benefit paid does not exceed $500 in that benefit year, $250 will be added to the next benefit year carryover maximum. This amount will accumulate from one benefit year to the next, but will not exceed $1,000.
Diagnostic & Preventive Services |
Basic Dental Services |
*Major Dental Services |
100% |
70% |
50% |
*There is a 12 month waiting period for all members for Major Dental Services.
SAVE ON THE CARE YOU NEED2
For example: A dentist may submit a $950 charge for a crown. With dental insurance, the dentist accepts a reduced fee of $744. That's an immediate savings of $206! Furthermore, having dental insurance means the carrier pays a percentage from the reduced fee so you can see how the advantages of dental coverage can add up quickly.
For an In-Network Dentist:2
Submitted Fee
$950.00
Max Approved Fee $744.00 |
X |
Coverage Level 50% |
= |
Renaissance Pays $372.00 |
You Pay
$372
61% decrease from the dentists fee!
2 The payment example above is for illustrative purposes only. Fees and reimbursements can vary by location and dentist. It does however represent how the payment is determined.
Difference Between In- & Out-of-Network Benefits:
In-Network Benefits
Based on the negotiated contracted dentist fee schedule. Using in-network dentists, the member can save more because the significant contracted discounts will result in less out-of-pocket expenses. By saving, the member will be able to receive more services during the year than if the member sees a non-contracted dentist.
Out-of-Network Benefits
Based on the local UCR charges. By seeing an out-of-network dentist, you have the freedom to choose any dentist and still have the benefits paid at the same coinsurance percentages. However, your annual maximum could be met sooner since the out-of-network dentists don't offer the same contracted discounts.

More than 1 in 5 people said that they had not visited the dentist in the last few years.1
40.2% of adults indicated that they will forgo dental care due to cost.1
1 Stats taken from: Health Policy Institute (ADA American Dental Association) http://ada.org/en/science-research/health-policy-institute/dental-statistics/patients

THIS IS NOT COMPREHENSIVE MAJOR MEDICAL INSURANCE. THIS IS A DENTAL ONLY POLICY.
The information is a limited description of the plan highlights. For more details, limitations, exclusions and definitions, please refer to the Certificate. Insurance benefits are underwritten by Renaissance Life & Health Insurance Company of America, Indianapolis, IN and in New York by Renaissance Life & Health Insurance Company of New York, New York, NY. Both companies (“Renaissance”) can be reached at P.O. Box 1596, Indianapolis, IN 46206. There is no ownership affiliation between Renaissance and Gap Dental & Vision. For complete coverage details, please refer to the certificate of insurance.
DIAGNOSTIC & PREVENTIVE DENTAL SERVICES INCLUDE

ORAL EXAMS
Twice / 12 Months

CLEANINGS3
Twice / 12 Months

X-RAYS FULL MOUTH SERIES4
X-Rays - Bitewing 5

FLUORIDE TREATMENT
To Age 19 - Twice / 12 Months

SEALANTS6
To Age 16 - Once / 36 Months

SPACE MAINTAINERS
Harmful Habit Appliances
*Diagnostic & Preventive Services also include Oral CDx BrushtTest®, an oral Brush Biopsy that can detect precancerous cells & oral cancer in its earliest stages.
3 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. (see Limitations & Exclusions for details).
4 Full Mouth X-rays are payable once in any 5 year period.
5 Bitewing X-rays are payable once per benefit period.
6 Sealants are payable only for the occlussal surface of the first and second permanent molars to age 16. The surface must be free from decay and restorations. Sealants are payable once per tooth per 3 year period.
Basic Dental Services Include

FILLINGS7

SIMPLE EXTRACTIONS8

NON SURGICAL
PERIODONTIC SERVICES9

EMERGENCY PALLIATIVE
TREATMENT10
Plus other Basic Services - miscellaneous services
7 Minor Restorative Services
8 Non Complicated Extractions
9 To treat gum disease - We allow for two cleanings or two perio maintenance visits, or a combination of both but no more than two in a benefit year.
10 To temporarily relieve pain
MAJOR DENTAL SERVICES INCLUDE

SURGICAL PERIODONTIC
PROCEDURES11

ENDODONTIC SERVICES
(I.E. ROOT CANALS)

COMPLEX EXTRACTIONS
& DENTAL SURGERY12

TMD
TREATMENT13

CROWNS AND
VENEERS14

BRIDGES, IMPLANTS
& DENTURES15

RELINES & REPAIRS OF
BRIDGES & DENTURES

*Waiting Period on Major Dental Services is 12 months for all Members.
11 To treat gum disease
12 All other Oral Surgery Services
13 Treatment of Temporomandibular Joint Dysfunction - Treatment is limited
14 Major Restorative Services (Crowns & Veneers are payable once per tooth per 5 year period)
15 Prosthodontic Services (Bridges & Dentures are payable once per tooth per 5 year period; Implants are payable once per tooth per lifetime)
HOW TO FILE A DENTAL CLAIM
United Business Association Claims Unit
Renaissance Life & Health Insurance Company of America
Po Box 17250
Indianapolis, IN 46217
Eligiblity & Benefit Info: 888.358.9484
Benefit payment is subject to the plan provisions, limitations, exclusions and other provisions within the Certificate. For more information and complete details of terms, conditions, limitations, and exclusions of coverage, please refer to the Certificate. Coverage may vary and may not be available in all states. Renaissance Life & Health Insurance Company of America and Renaissance Life & Health Insurance Company of New York do not provide or are they affiliated with the discount programs provided as part of membership in the United Business Association.
United Business Association
The United Business Association (UBA) is a nationwide membership of small business owners and employees. UBA leverages our purchasing power to secure benefits and discounts that may not be otherwise available on an individual basis. With association group insurance programs, shared business knowledge, business and lifestyle benefits and services and opportunities to network, We are Better Together. Your membership in the United Business Association allows you to access and enroll in association group insurance programs and apply for association short term medical insurance. Various insurance companies have issued group limited benefit insurance policies to the United Business Association as the group master policyholder. Product features, additional plans and availability may vary by state. View UBA's Refund / Cancellation Policy.
*Plan Costs listed at the top of the page do not include the separate $10 UBA Membership dues. You must be a member of the United Business Association to access and enroll in this Gap Plan.