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Gap Plus Plan - www.gapplusplan.com - Member Driven Value
Gap Dental Plan - www.ubamembers.com - Member Driven Value.

Gap Dental Plan

Select here to Apply Now to UBA Membership and Gap Dental Plan

(Plan Costs* for Gap Dental Plan are below in Plan Cost Tab)

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Select here to view Gap Dental Plan Sample Member Guide for details on plan

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.

Broad Coverage for Brighter Smiles.


Group Dental Insurance - Gap Dental Plan

GROUP DENTAL INSURANCE



Select here to view Gap Dental Plan Exclusions & Limitations

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.



Did you know - Dental Statistics for Gap Dental Plan

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



Renaissance Dental - Gap Dental Plan

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.



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Diagnostic & Preventive Dental Services*

100% Coinsurance

In- or Out-of-Network

DIAGNOSTIC & PREVENTIVE DENTAL SERVICES INCLUDE

Oral Exams - Twice 12 months - Diagnostic & Preventive Dental Services- Gap Dental Plan

ORAL EXAMS
Twice / 12 Months

Cleanings - Twice 12 months - Diagnostic & Preventive Dental Services - Gap Dental Plan

CLEANINGS3
Twice / 12 Months 

X-rays Full Mouth Series - X-rays Bitewing - Diagnostic & Preventive Dental Service - Gap Dental Plan

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

Fluoride Treatment - Diagnostic & Preventive Dental Services - Gap Dental Plan

FLUORIDE TREATMENT
To Age 19 - Twice / 12 Months 

Sealants - To age 16 - Once / 36 months - Diagnostic & Preventive Dental Services - Gap Dental Plan

SEALANTS6
To Age 16 - Once / 36 Months 

Space Maintainers - Harmful Habit Appliances - Diagnostic & Preventive Dental Services - Gap Dental Plan

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.

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.

BACK TO GAP DENTAL INSURANCE SECTION

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Basic Dental Services

70% Coinsurance

In- or Out-of-Network

Basic Dental Services Include

Fillings - Basic Dental Services - Gap Dental Plan

FILLINGS7

Simple Extractions - Basic Dental Services - Gap Dental Plan

SIMPLE EXTRACTIONS8

Non-Surgical Periodontic Services - Basic Dental Services - Gap Dental Plan

NON SURGICAL
PERIODONTIC SERVICES9 

Emergency Palliative Treament  - Basic Dental Services - Gap Dental Plan

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

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Major Dental Services*

50% Coinsurance

In- or Out-of-Network

MAJOR DENTAL SERVICES INCLUDE

Surgical Periodontic Procedures - Major Dental services - Gap Dental Plan

SURGICAL PERIODONTIC
PROCEDURES11 

Edodontic Services (ie root canal) - Major Dental Services - Gap Dental Plan

ENDODONTIC SERVICES
(I.E. ROOT CANALS) 

Complex Extractions & Dental Surgery - Major Dental Services - Gap Dental Plan

COMPLEX EXTRACTIONS
& DENTAL SURGERY12 

TMD Treatment - Major Dental Services-  Gap Dental Plan

TMD
TREATMENT13 

Crowns and Veneers - Major Dental Services - Gap Dental Plan

CROWNS AND
VENEERS14 

Bridges, Implants & Dentures - Major Dental Services - Gap Dental Plan

BRIDGES, IMPLANTS
& DENTURES15 

Relines & Repairs of Bridges & Dentures - Major Dental Services - Gap Dental Plan

RELINES & REPAIRS OF
BRIDGES & DENTURES 

Gap Dental Plan - Major Dental Services

*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)

BACK TO GROUP DENTAL INSURANCE SECTION

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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.

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