FAQ

FREQUENTLY ASKED QUESTIONS


Office Questions
 
•  I haven't received my ID card yet, but I have an appointment scheduled. What information does my provider need? How can I obtain an ID card?
May I visit any dentist I wish for treatment? What if my dentist doesn't participate with Surency Life & Health Insurance Company?

 

Insurance Questions
 
•  What is Surency Life & Health's mailing address?
I just received something in the mail from Surency that looks like a bill. What is it?
What are predeterminations and are they mandatory?
Does my group coverage run on a calendar year or contract year?
Does Surency Life & Health Insurance Company offer individual policies?
Does Surency have waiting periods for services?
I'm covered under two dental plans. How is my coverage handled?
Do I need a referral to see a specialist?
How do I check to see if I am eligible for coverage?
Can I add a family member to my dental coverage at any time?
What does Surency Life & Health consider a qualifying event?
Can I elect coverage in the middle of a contract year?
When does coverage begin after there has been a qualifying event?
How do I get an explanation of my dental coverage?
When am I eligible for dental coverage?
 
Claim Questions
 
•  I had a tooth pulled (extracted) and the insurance claim was filed with my medical insurance. Why doesn't my dental insurance cover the claim?
Why does Surency Life & Health reimburse orthodontic payments monthly instead of paying the entire amount up front?
Why did Surency Life & Health pay for a silver (amalgam) filling in my back tooth when my dentist filled the tooth with a white (composite) filling?
Why was my exam not covered when my dentist referred me to a specialist?
I had individual x-rays taken and Surency paid for a full mouth x-ray. Why?
 
Dependent Questions
 
•  My child has braces and we just switched to Surency Life & Health. Are our orthodontic payments covered under our Surency insurance?
Why was my son/daughter taken off my dental policy?
What do I need to send to Surency Life & Health to verify my child's full-time student status?
I have a dependent who is fully disabled; how long is he/she covered under my policy?
Can I add family members to my dental coverage at any time?

 

COBRA Questions
 
•  How do I apply for COBRA coverage?
Are all employers required to offer COBRA coverage?
When does my COBRA coverage start?
I have not received a bill for my COBRA coverage. What do I do?
How do I terminate my COBRA coverage?

 

 

Office Questions

Q: I haven't received my ID card yet, but I have an appointment scheduled. What information does my provider need? How can I obtain an ID card?

A: Your dental office will need your social security number or member identification number. The dentist's office may also call our office to verify coverage. You can print ID cards by selecting the Print ID Cards tab within the Member Login section.


Q: May I visit any dentist I wish for treatment? What if my dentist doesn't participate with Surency Life & Health Insurance Company?  

A: You are free to visit any dentist. However, you may have more out-of-pocket expense and will be responsible for the difference between Surency's payment and the non-network dentist's fee, along with your co-pay. In addition, depending on your employer-selected benefit plan, your coverage may involve a larger deductible if you go to a dentist who doesn't participate with your plan.

 

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Insurance Questions

Q: What is Surency Life & Health's mailing address?

A: P.O. Box 789773, Wichita, KS 67278-9773.


Q: I just received something in the mail from Surency that looks like a bill. What is it?

A: You probably received an Explanation of Benefits (EOB) statement. This statement is not a bill; it explains what services your dentist provided and how Surency processed and paid for the services.

Q: What are predeterminations and are they mandatory?

A: Some groups and some conditions require a predetermination of services before treatment is performed. A predetermination of benefits allows you to know in advance exactly what procedures are covered, the amount your plan will pay toward treatment and your financial responsibility. Treatment plans that involve Covered Services which include prosthodontic services, orthodontic services, individual crowns (except stainless steel), gold restorations, surgical periodontics, endodontics, and oral surgery except for simple extraction of a single tooth, should be submitted to Surency Life & Health for predetermination of benefits. Please refer to your benefits booklet to see the exact services for which predeterminations are required. Even if it is not required, Surency encourages predeterminations for extensive treatments, or if you visit a non-participating dentist. There is no charge for a predetermination and it is valid for ninety (90) days.

Q: Does my group coverage run on a calendar year or a contract year?

A: The anniversary date for coverage varies from group to group. Please check with your employer for specific information on your group benefits and benefit year.


Q: Does Surency Life & Health Insurance Company offer individual policies?

A: Surency Life & Health is a group dental benefits administrator. Therefore, we are not providing individual dental plans at this time.

Q: Does Surency have waiting periods for services?

A: Surency does not impose waiting periods, so members have immediate protection for all covered services. However, some employer groups have waiting periods. Please check your benefits booklet to see if your group imposes waiting periods or visit the Member Login to view your waiting period.


Q: I'm covered under two dental plans. How is my coverage handled?

A: If you and your family are covered by both Surency Life & Health and another dental carrier or medical plan that offers dental coverage, Surency coordinates benefits with the other benefits carrier. Generally, if you are covered as an employee and as a dependent of an employee at another company, the coverage through your employer is primary. Children covered by parents who work for different employers are usually primary under the plan of the parent whose birthday occurs first in a calendar year (not necessarily the oldest parent). In determining coverage, total payments from both carriers cannot exceed 100 percent of the approved fee for the service. Please note that some groups have specified a "carve-out" clause in their dental programs that might limit a secondary carrier's payment. If you have a question about Coordination of Benefits (COB), please contact our Customer Service department at 866.818.8805.

Q: Do I need a referral to see a specialist?

A: If you're a member of Surency Life & Health, you do not need a referral to receive care from a specialist. However, we strongly encourage you to use the services of a participating specialist to maximize your benefit coverage and to get a predetermination.

Q: How do I check to see if I am eligible for coverage?

A: It's easy to check your current eligibility status and view a summary of your plan's dental benefits online by visiting the Member Login section or contact our Customer Service department at 866.818.8805.

Q: Can I add a family member to my dental coverage at any time?

A: No. Dependent family members can only be added at the renewal date of the group contract if the employer allows open enrollment periods, or when a qualifying event occurs.

Q: What does Surency Life & Health consider a qualifying event?

A: The following are considered qualifying events:
• Birth/legal custody/adoption 
• Death
• Loss of other dental insurance coverage
• Marriage/divorce
• Newly hired


Q: Can I elect coverage in the middle of a contract year?

A: Coverage can be elected during the middle of the contract year only if a qualifying event occurs.

Q: When does coverage begin after there has been a qualifying event?

A: Coverage begins the first of the month following the date of the qualifying event. Surency Life & Health must receive notice of the change in eligibility status within 31 days of the qualifying event. Otherwise, the change may only be made at the renewal date of the group contract if the employer allows such open enrollment.

Q: How do I get an explanation of my dental coverage?

A: A dental benefits summary is available online via our Member Login. A Benefits Booklet explaining coverage is mailed to each new enrolled employee within 30 days of the effective date of coverage.

Q: When am I eligible for dental coverage?

A: It's easy to check your current eligibility status and view a summary of your plan's dental benefits online by visiting the Member Login or by contacting our Customer Service department at
866.818.8805.

 

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Claim Questions

Q: I had a tooth pulled (extracted) and the insurance claim was filed with my medical insurance. Why doesn't my dental insurance cover the claim?

A: Only claims for surgical extraction of wisdom teeth should be submitted first to your medical insurance carrier and then to your dental insurance. Some medical plans pay up to 100% of this procedure, so filing this type of extraction with your medical insurance could be of benefit to you. If there are any remaining charges after the medical insurance carrier has paid, your dental plan may cover the remainder or a portion of the remainder.

Q: Why does Surency Life & Health reimburse orthodontic payments monthly instead of paying the entire amount up front?

A: Orthodontic payments are distributed throughout the period of time the services are rendered. This eliminates problems and confusion if the treatment is completed early, if the member's coverage is terminated, if the group switches dental coverage to another carrier, or if the dependent reaches the age limit for orthodontic benefits or for dependent coverage, in general. Surency's policy is to pay only for completed services, so once the monthly visit is completed, a payment will follow.

Q: Why did Surency Life & Health pay for a silver (amalgam) filling in my back tooth when my dentist filled the tooth with a white (composite) filling?

A: Your plan only covers the cost of an amalgam (silver) filling in a posterior (back) tooth. If you and your dentist decide to restore the tooth with a composite resin, Surency will allow for the cost of the amalgam, and you will be responsible for the remaining cost.

 

Q: Why was my exam not covered when my dentist referred me to a specialist?

A: According to your contract, an examination is only covered within a certain period of time. This is true whether the examination is performed by a general dentist or by a specialist. Visit our Member Login section to view your benefits and eligibility.


Q: I had individual X-rays taken and Surency paid for a full mouth X-ray. Why?

A: Surency's policy states the combined total fee for individual (periapical) or bitewing X-rays cannot be higher than the fee for a full-mouth series. If this occurs, Surency will pay for a full-mouth series.

 

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Dependent Questions

Q: My child has braces and we just switched to Surency Life & Health. Are our orthodontic payments covered under our Surency insurance?

A: Surency Life & Health will assume coverage of orthodontic benefits only if your employer's previous dental carrier was making orthodontic payments at the time Surency took over the group. It also must be specified in your group's contract that it is takeover coverage. Standard processing policy is that if you are a new employee and had a dependent in orthodontic treatment prior to your employment with this company, Surency will not cover your existing orthodontic payments.


Q: Why was my son/daughter taken off my dental policy?

A: Under most group dental plans, dependents over age 19 are not eligible for dental coverage unless they are full-time students, earning at least 12 credit hours per semester. If your child is eligible for student coverage, please notify your group so he/she can be reinstated on your policy.


Q: What do I need to send to Surency Life & Health to verify my child's full-time student status?

A: We need a copy of a document providing proof that the student is enrolled in at least 12 credit hours (e.g., a copy of a paid tuition bill indicating class schedule or a letter from the registrar).

Q: I have a dependent who is fully disabled; how long is he/she covered under my dental policy?

A: As long as the individual remains disabled, unmarried and is fully dependent on you for support, he or she can remain a dependent on your insurance policy. Written proof is required from the attending physician to verify the dependent's condition.

 

Q: Can I add family members to my dental coverage at any time?

A: Dependent family members can only be added during open enrollment periods through your employer, or when a qualifying event occurs.

 

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COBRA Questions

Q: How do I apply for COBRA coverage?

A: You should contact your former employer regarding eligibility for COBRA coverage and to request an application for continuation of group dental coverage.

 

Q: Are all employers required to offer COBRA coverage?

A: Not all employers are obligated to offer COBRA coverage. Please check with your former employer for information on COBRA coverage. COBRA signup periods vary, so please also check with your former employer regarding enrollment deadlines and length of coverage.

 

Q: When does my COBRA coverage start?

A: Normally, COBRA coverage begins the day following your last day of coverage. However, please check with your former employer for specific information. Check with your employer for information regarding your individual situation.

 

Q: I have not received a bill for my COBRA coverage. What do I do?

A: COBRA billing authority varies by employers. Your COBRA premiums may be collected by your former employer, by Surency Life & Health or by a third-party administrator hired by your former employer. You may contact Surency to inquire about payment procedures for your group. Federal law does not require us to provide a monthly billing statement. If Surency is responsible for collecting your payment, we may issue COBRA coupons to attach to your monthly payment, but it is the responsibility of the COBRA participant to make sure that their payment reaches the billing authority by the last day of the month for which premium is due. If payment is not received by the last day of the month for which premium is due, your COBRA coverage will be terminated and cannot be reinstated. (Example: Premium for October coverage is due on October 1, coverage will terminate if payment is not received by October 31).

Q: How do I terminate my COBRA coverage?

A: If you wish to terminate your COBRA coverage, for which Surency Life & Health is the billing authority, send written notification to our Eligibility department at P.O. Box 789773, Wichita, KS 67278-9773. Please include your name, date of birth, ID number, the requested termination date and contact information. If your former employer or a third-party administrator is the billing authority for your COBRA coverage, please contact them directly.

 

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