Dental Provider: | Reliance Standard Life Insurance (RSLI) |
|---|---|
| Dental Network: | Ameritas |
| Dental Group Number: | 420855 |
| Dental Carrier Phone Number | 1-800-497-7044 |
For more information about this plan see:
In order to access your certificate of coverage, you must visit www.reliancestandard.com/dental-vision and sign into your secure account, where you also have direct access to your benefit information and the most current and complete provider listing.
For questions regarding your dental benefit coverage or concerns contact RSLI's customer relations department at 1-800-497-7044 Monday through Thursday, 7:00 am – midnight and Friday, 7:00 am – 6:30 pm Central Time.
Monthly Premium Rates
Plan Options: | Employee only | Employee + 1 (Spouse or Child) | Employee + 2 or more (Family) |
|---|---|---|---|
| Tier One "Low" Plan (Dental 1250) | $40.24 | $79.28 | $122.44 |
Tier Two "High" Plan (Dental 1500) *See details below about Orthodontia coverage | $49.92 | $98.44 | $152.08 |
IMPORTANT: Tier Two "High" Plan (Dental 1500) Orthodontia Coverage Details
- The maximum lifetime Orthodontia benefit per person is $1500, if you select the Tier two (Dental 1500) Plan.
- $1500 Orthodontia benefit is “in addition” to the annual benefit…so children on the plan in essence have $3,000 in benefit ($1,500 for general dentistry + $1,500 for Orthodontia services).
- There is a 12 month waiting period once someone enrolls in the Tier Two (Dental 1500) Plan before the Orthodontia benefits is available.
- Orthodontia coverage applies only to dependents age 19 and under.
Enrollment Form
If you wish to enroll in Dental coverage, please contact benefits@reliant.org. Keep in mind, you need a qualifying event to enroll in dental coverage outside of Open Enrollment. If you have a valid qualifying event, the Benefits Coordinator will send you an enrollment form via DocuSign.
Terminating or Changing Dental Coverage
Without a qualifying event, you can only terminate your dental coverage during Open Enrollment.
If you have a valid Qualifying Event, email benefits@reliant.org to request that your dental coverage be terminated. Include in your request the details of your qualifying event and the date you wish to terminate dental coverage.
Summary of Benefits
RSLI_benefits summary dental low&high
