mbf1

mbf2
sids2 Home

The MBF-SIDS SELECT DENTAL PPO program enables you and your covered family members to receive comprehensive dental care with little or no out-of-pocket expense. This program was developed as a cooperative effort by the Management Benefits Fund and SIDS Dental Consultants in 1986, and has been benefiting MBF members ever since.

SIDS monitors the performance of PPO providers to ensure that appointments are freely given and honored, and that fees do not exceed allowable charges. Accordingly, you should not pay the dentist any money except in the following few instances.

ANNUAL MAXIMUM PAYMENT:
The annual maximum payment for services completed prior to January 1, 2012 is $2,500 per person. The annual maximum payment for services completed after January 1, 2012 will be $4,000 per person. The lifetime maximum orthodontic benefit is $4,000.

DEDUCTIBLE:
The table below indicates the deductible amounts and the MBF co-insurance percentage for different services under the Dental Program:

IN-NETWORK OUT-OF-NETWORK
Annual Deductible (amount you must pay out-of-pocket to a provider before MBF will issue reimbursement) $50/individual
$150/family
$100/individual
$300/family
Preventive/Diagnostic (not subject to deductible) 100% 80%
Basic Restorative (extractions, fillings, root canals and periodontal treatment) 90% 70%
Major Restorative (crowns, dentures and bridges) 90% 70%


COPAYMENTS:
diagnostic & preventive services none
basic services (extractions, fillings root therapy, periodontal treatment) 10%
major restorative (crowns, dentures, bridges) 10%
implants 50%

FOR COVERED BUT NOT REIMBURSABLE SERVICES:
Certain dental services are listed in the Schedule as covered but may not be payable in some instances due to Dental Plan Limitations and Exclusions. For example, cosmetic restorations, or where frequency limitations are applied, or for services that exceed Plan maximums. In these instances the dentist may not charge you more than the Plan would otherwise have paid for these services.

FOR NON-COVERED SERVICES:
There are a few dental services that are not covered by the MBF Dental Plan. The dentist’s charge to you for a non-covered service may not exceed the reasonable and customary charge for that service.

COORDINATION OF BENEFITS:
If you are covered under more than one group dental plan, the dentist is entitled to benefits available from both plans. Payment from the second plan will be applied first to reduce or eliminate any charges to you resulting from plan maximums, limitations or exclusions.

In order to streamline claims processing, when you obtain your dental services from an MBF-SIDS SELECT PPO dentist, the dentist will be responsible for submitting all claims information. You will be expected to assign benefits on the claim form so that the dentist may be paid directly by the Fund.

To take advantage of this program, simply select a dentist by clicking “find an MBF/SIDS dentist”. You will be provided with the names, addresses and telephone numbers of local MBF-SIDS PPO dentists, as well as certain other information relating to their professional qualifications and office facilities. All you need do is call the dentist directly for an appointment. No identification card is necessary. Occasional changes to the provider list are possible, so it is important to confirm that the dentist is a current MBF-SIDS PPO provider. You, and each of your family members, are free to select or change your dentist without notification. The selection of a dentist is your responsibility. Neither MBF nor SIDS recommends or endorses any particular dentist.

The Management Benefits Fund and SIDS are committed to maintaining the high standards of care that are fundamental to the program’s success, and we need your help. Your reaction to the services you receive is essential. We ask you to complete the patient satisfaction questionnaire which can be accessed by clicking “patient satisfaction survey”.

Among other useful features, this Website offers informational articles about many dental topics by clicking “dental health topics for you and your family”.

You should not hesitate to click on ”send us your comments and suggestions” to send us an e-mail with your specific questions, concerns or recommendations regarding the operation of the program or the services you received.