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UHC Specialty Updates: Missing Tooth Clause, Ineligible SIC Codes, Dual Option Dental

UHC provided three important updates on their Specialty products.


Missing Tooth Clause

More and more frequently, groups are looking for implant coverage on their dental plan. UHC’s Flex Appeal Enhanced plans (X series) include coverage for implants, white composites and up to 4 cleanings per year. 


Something important to note is that some competitors include a missing tooth clause. This means that if the tooth was missing before the member was covered under the plan, implant coverage may not apply. 


UHC dental plans (X series), without waiting periods on major services, do not include a missing tooth clause. This can be highlighted when positioning UHC!


SIC Codes for Dental & Vision

Please note that UHC is not able to quote or install dental and vision plans for certain SIC codes.


UHC cannot quote dental for the following SIC code:

  • SIC code – 8021 (Offices & Clinics of Dentists)


UHC cannot quote vision for the following SIC code:


  • SIC code – 8042 (Offices & Clinics of Optometrists)


Dual Option Dental

Pairing two dental plans together can be a great option for groups by allowing more choice for members. Here are the guidelines:


2 Dental PPO Plans:

  • Must have at least 2 differences in plan design
  • At least 20% relativity difference between the 2 plans
  • Example:
    • Base plan 100/80/50 MAC without ortho 
    • Buy-up 100/100/60 UCR with ortho and implant coverage
  • Minimum of 10 enrolled between the 2 plans


DHMO and PPO Dental Plans:

  • Requires 5 eligible and 3 to enroll between the 2 plans


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