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EMPLOYERS
DENTAL
TRUST
Plans may not be available in certain States. Please contact the Managing Agency Group for details.
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- Stand alone dental 2+ lives
- Orthodontia available at 5 lives
- Ameritas national PPO dental carrier
- Outstanding Billing, Claims and Administration
- Dental Provider Lookup (Select PPO as your network)
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Sales Kit
- About Employers Dental Trust
- About Ameritas
- 2 Star Summary (waiting period incl.)
- 3 Star Summary (waiting period incl.)
- Plan Highlights
- Covered Expenses and Exclusions
- Dental Rewards
- Dental Terminology
- Eligibility and Participation
- Late Entrant and Voluntary Rules
- Complete kit
- Authorization to Release Information – Claims
- Ameritas HIPAA Release Form
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Rating Package (8-1-08 thru 1-1-09 New Business)
- Area 1: AL, AR, DE, IN, OH, KY, MS, RI, WV, PA
- Area 2: MI, NC, SC, PA
- Area 3: CO, DC, FL, GA, MA, MD, ME, MO, UT, VA, VT, WI
- Area 4: CT, NH, NJ
- Area 5: CA
- Plan Adjustment Factors
Application Package
- Application and Participation Request
- Commission Agreement
- Enrollment and Refusal Form
- Census Form
- New Business Checklist
- Dental Group Claim Form
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