Page History
Dental Provider: | Reliance Standard Life Insurance (RSLI |
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Dental Network: | Ameritas |
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Dental Group Number: |
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420855 | |
Dental Carrier Phone Number | 1-800-497-7044 |
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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) |
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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 |
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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.
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RSLI_benefits summary dental low&high
RSLI Dental Plan Documents: Full Policy Details
At the time of employment, an employee (and their dependents) can be covered fully. The employee has 30 days to start this coverage.
After the initial qualifying employment period, employees and their dependents may enroll for Dental Coverage during Open Enrollment season. However, at this later date, they will be considered a "Late Entrant," which means that allowed benefits are limited to preventative care during the first 12 months of enrollment.
To enroll in RSLI Dental Insurance at the time of employment, please fill out the Enrollment Form below and submit it to benefits@reliant.org.
To add a dependent child before their third birthday is considered a qualifying event. Your child is covered automatically whether you enroll or not for the first 18 months since babies don’t usually have teeth, nor need coverage. After the first 18 months, you have until 31 days following the 3rd birthday of your child to enroll them in dental coverage. If you wait until after 31 days following the third birthday, your child would be considered a late entrant and you will be able to enroll them while participating in Open Enrollment. Being enrolled as a late entrant will only give them preventative care for the duration of 1 year until they qualify for full coverage.
To enroll a dependent child please complete the NEED ENROLLMENT FORM and submit it to benefits@reliant.org .
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If you need to download a dental insurance card, see Dental Insurance Card |
Monthly Premium Rates
Coverage level | Cost |
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Employee | $37.12 |
Employee + One | $73.15 |
Family | $112.98 |
Enrollment form
Complete the following sections (Product Selection, Dependent and Other Insurance Information, Request for Coverage) and sign and date the form.
Other plan documents
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