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Dental Provider:

Reliance Standard Life Insurance (RSLI)

http://www.reliancestandard.com/dental-vision/

Dental Network:

Ameritas

https://dentalnetwork.ameritas.com/

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)
35
$40.
28
24
69
$79.
52
28
107
$122.
36
44

Tier Two "High" Plan (Dental 1500)

*See details below about Orthodontia coverage

43
$49.
80
92
86
$98.
36
44
133
$152.
40
08


Warning
titleIMPORTANT: 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 annual general dentistry + $1,500 for Orthodontia services).
  • Normally there There is a 12 month waiting period once someone enrolls in the Tier Two (Dental 1500) Plan before the Orthodontia benefits is available.
  • RSLI waived the 12 month waiting period for Orthodontia coverage for employees that elect in Open Enrollment to begin coverage on the Tier Two (Dental 1500) Plan starting January 1, 2019 (for benefits provided in 2019).
  • If an employee didnot enroll in the Tier Two (Dental 1500) Plan during 2019 Open Enrollment, any future enrollment in this plan will include a 12 month waiting period for Orthodontia coverage. In this scenario the employee will have to be enrolled in the Tier Two (Dental 1500) Plan for an entire calendar year prior to receiving any Orthodontia coverage for their dependents.
  • Orthodontia coverage applies only to dependents age 19 and under.

 

Summary of Benefits:

For participants whose coverage was effective 1/1/2019 (no waiitng period for Orthodontia coverage)

View file
nameRSLI_ben summ dental low&high_enrolled 1.1.19.pdf
height250

 

For participants whose coverage was effective after 1/1/2019 (one-year waiting period for Orthodontia coverage)

View file
nameRSLI_ben summ dental low&high_enrolled after 1.1.19.pdf
height250

 

  • 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.

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Summary of Benefits

RSLI_benefits summary dental low&high

RSLI Dental Plan Documents: Full Policy Details

Tier One Plan Summary

Tier Two Plan Summary