UHC Specialty Updates: Dental Plan Codes, Waiting Periods, and Networks

UHC provided the following important updates on their Specialty products.

Dental Plan Codes

P plans

• Traditional PPO

A plans

• Endo/Perio/OraI in Class III
• Full Mouth & Panoramic X-rays shift from Class I to Class II
• MAC or 70% UCR

H plans / FlexAppeal Preventive MaxMuItipIier

• Operates like PPO
• Requires 5 eligible
• Preventive & Diagnostic
• Services not applied to the Annual Maximum

X plans / FlexAppeal Enhanced

• Operates like PPO
• Requires 5 eligible
• Implant coverage
• Posterior composites (white fillings)

See UHC's flyer for more information:

• (A) Gateway Plans
• (H) FlexAppeal Preventive MaxMultiplier
• (X) FlexAppeal Enhanced

Waiving the Dental Waiting Period at Install

If a group selected a dental plan with a waiting period for major services, they can get that waiting period waived for the initial enrolling employees if they provide the following information

1. Proof of prior coverage for major services. This requires a benefit summary, certificate of coverage or an explanation of benefits from the prior carrier showing coverage for major services.
2. Proof of prior coverage for the preceding plan year. This could in the form of a renewal from the prior carrier showing coverage dates or a recent bill and a year-old bill.

Click here for to see UHC's Waiving the Dental Waiting Period flyer for more information.

Dental Network

If you are unsure which dental network your plan uses, check the out-of-network reimbursement level.

• UCR — National Options PPO 30
• MAC — National Options PPO 20
• INO — National Options PPO 20
• SMC/DHMO — National Select Managed Care

The dental benefit summaries also list the network at the very top.

For questions or help with a UHC Specialty quote, please contact a member of your B&P Sales Team - 888.722.3373.