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SureBridge Upcoming Audits: Waivers for Dental Waiting Periods

September 20, 2022

Qualifying for Waiver of Waiting Period on Dental Plans

As a reminder, customers applying for a PPO Premiere Dental plan, may qualify for a Waiver of the Waiting Period on their new PPO Premiere plan if:

  • The new plan is replacing an existing comprehensive dental coverage* plan
  • The plan being replaced was in force for at least the past 12 consecutive months, and
  • The plan being replaced had no gaps in coverage greater than 63 days

To help your customer qualify for the waiver, please ensure the information provided on the application about their current dental coverage (effective date, termination date, company name and policy number) is accurate. SureBridge will monitor the information accuracy with random monthly audits that occur within the first 30 days of coverage.

What if my customer is selected for an audit?

Customers selected for the audit will be asked to provide a letter of creditable coverage from their previous dental carrier verifying they had full dental coverage.

The letter should have:

  • Names of all individuals listed on the dental coverage
  • Dates of coverage for the individuals with full dental coverage benefits, and
  • Be on the carrier’s letterhead

The letter of creditable coverage needs to be received by our office (email, mail or fax) within 21 days of the request

What do I need to do as the agent?

If your customer is selected for the audit, SureBridge will notify you by email and provide the customer's contact information. They are asking for your help obtaining the letter of creditable coverage from your customer, so they can continue to benefit from the Waiver of Waiting Period on the new coverage.

SureBridge appreciates your help with this request and hope you find the Waiver of Waiting Period to be a value-add for your clients.

Before you re-write  that SureBridge dental plan…

If you have SureBridge dental customers that are aging into Medicare, you don’t have to re-write them to a "senior" dental plan. SureBridge dental plans are designed for all ages. Unless your client needs to add or reduce plan  benefits, moving your client to a new dental plan can potentially increase their premium and create disruption of their dental benefits. A new plan means having to start over with any deductibles or waiting periods. If you  have questions about our dental plans, please reach out to Producer Support with questions.

* A comprehensive dental plan has benefits comparable to Types I, II, and III coverage levels offered with SureBridge  Dental plans (e.g. restorative, endodontic, periodontic, prosthodontic, and  oral surgery)

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Questions? Call us at 855-888-8326.

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