CASEBP and Ameritas make it easy for you to understand and use your benefits. The answers to these frequently asked questions can get you started. Still having trouble? Contact CASEBP at casebp@oncboces.org or (607) 588-8917 or Ameritas at group@ameritas.com or 1-800-659-5556.

ID CARDS

Where can I get an ID card? You can access, view, print, and save your personalized ID card in your Secure Login (ameritas.com).
Do I need an ID card? No, you don’t need an ID card. ID cards are provided as a convenient way to present your insurance information to the dentist. In place of an ID card, you may give your dental office your group number, which includes your policy/division/certificate number. Contact CASEBP or Ameritas if you don’t know your group number.
How do I obtain a corrected ID card if there’s an error on it? You should contact your district’s assigned Benefits Administrator to have any information updated.
What is my ID number? Your ID number is the policy number/division number/certificate number listed on your ID card.

PLAN BENEFIT INFORMATION

Are teledentistry services covered? All services under our plans are covered when appropriately delivered through teledentistry services. They are subject to the same plan benefits and limitations as equivalent services that are not provided through teledentistry.
How do I obtain a copy of my dental benefit information? Once you’re enrolled in the group plan, you’ll receive a certificate outlining your dental benefits. Contact CASEBP or Ameritas if you haven’t received a certificate. You can also access benefit information online by signing into your secure member account or on the Dental Coverage page on the CASEBP website.
Who is authorized to obtain benefit information and claim status on my dental policy? In accordance with the Health Insurance Portability and Accountability Act (HIPAA) we are required by law to maintain the privacy of our insured members’ and their dependents’ protected health information. If you are an insured member, the privacy law allows you to obtain benefit information and the claim status of all individuals insured under your dental policy. If your spouse is on the policy, he or she is allowed to obtain information on dependents under the age of 18. If you’d like to authorize others to access benefit information, complete our Privacy Form and submit it to Ameritas at Privacy Office, PO Box 81889, Lincoln, NE 68510; Fax: 402-309-2580
How long is a child considered an eligible dependent? A child is considered an eligible dependent until their 26th birthday. Coverage will end at the end of the month when the child turns 26.
Are there any waiting periods for benefits? You must have been enrolled in the Plan for at least 12 consecutive months before the date coverage is requested for any prosthetic or orthodontic benefits.
How many exams, cleanings and x-rays are covered? The Plan covers two routine evaluations, two cleanings, and two bitewing x-ray sets in each plan year. One full mouth x-ray or panorex x-ray is covered in any 36-month period.
My periodontal specialist told me I should have three or four cleanings a year, but my plan only covers two….why? The number of covered cleanings for each benefit period is established by the benefits and limitations/exclusions of the Plan. We are obligated to apply the plan provisions consistently for all members regardless of individual circumstances. Our denial of your additional cleanings doesn’t suggest that the services shouldn’t be performed. We do not intervene in treatment decisions between a dental provider and patient, nor do we determine dental necessity.
Is wisdom tooth removal (oral surgery) covered? Oral surgery falls under the Basic category. Please refer to your plan document for plan coverage amounts. A pre-operative x-ray film is required to review a surgical extraction because benefits are subject to our consultant’s review. We require a pretreatment estimate for any services anticipated to cost over $600.00.

DENTAL PROVIDERS AND DENTAL APPOINTMENTS

Can I see my dentist or am I required to choose one from the Ameritas network? You are free to visit any dentist you choose. Your benefits are the same for in and out-of-network providers. If you choose to see an out-of-network provider, CASEBP will cover up to the Allowable Expense for Covered Services performed by a Professional Provider, and the provider has the right to bill you for anything above that amount.
How do I know if my dentist is part of the Ameritas network? Search for your dental provider in the online provider directory on this website.
Do I need a referral to see another dental provider? No. You are welcome to seek treatment from any dentist you choose.
How much will I have to pay at the time of my appointment? You may be responsible for your coinsurance. However, some dental offices will not collect the coinsurance until after the insurance company has processed the claim. Contact your dental office to ask how their billing process works.
Do I need to bring a claim form? In most instances, you do not need to bring a claim form with you. If the dental office submits insurance claims for you, they already have claim forms. However, if the dental office requires that you file your own claim(s) with insurance, please make sure the dental provider gives you a statement. Complete only the top portion (Part 1) of a claim form with the patient and member information, attach a copy of the provider statement, and submit to Ameritas at Group Claims, PO Box 82520, Lincoln, NE 68501, Fax: 402-467-7336.
Can I visit a dental provider in a foreign country? Yes, however we only honor assignment of benefits to providers in the United States. Since services provided outside the United States must be reimbursed directly to the member, foreign-based providers typically require payment in full before services are completed.

CLAIMS, PAYMENTS, AND BENEFIT STATEMENTS

How do I submit a claim? Claims can be submitted by you or your dentist. Network providers will submit the claim for you. You can view submitted claims, explanation of benefit (EOB) statements and more in your secure member account or contact Ameritas. Claims that don’t require X-ray films may be faxed to 402-467-7336. All claims can be mailed to: Group Claims, PO Box 82520, Lincoln, NE 68501-2520.
Who submits the claim or pretreatment estimate? If you go to a provider who is on the Ameritas network, they will submit claims and pretreatment estimates for you. However, if you see a non-network provider, you’ll need to contact your dental office and ask if they will submit the claims or pretreatment estimates for you.
How much time do I have to submit a claim? We recommend that claims be submitted as soon as possible, as dental plans have a timely filing clause. Claims submitted after 12 months of the last date of treatment on the form will be denied due to failure to meet the timely filing requirements.
Will you send benefit payments to me or to the provider? If services are performed in the United States, we will assign benefits according to how they are authorized on the claim form. If services are performed outside the United States, benefits will automatically be assigned to the insured member. If you visit an Ameritas provider, benefits are automatically issued directly to the provider based on their contractual agreement. For non-network providers, benefits can be assigned to the insured member or to the provider. If you would like the benefits assigned to you, please leave the authorization line blank on the claim form.
Do I need to get a pretreatment estimate for a procedure? If you expect a single dental treatment to cost more than $600.00, you must obtain a pretreatment estimate from your Professional Provider. The provider should include an estimate of charges and copies of x-rays, photographs, and models, if appropriate, in the request for the pretreatment estimate.
How are orthodontic benefits paid? Payments are made to you monthly over the course of the treatment. Payment is not automatic. You must submit the bill for reimbursement each month before payment will be made.
Why did you take the coinsurance again on my claim? I already paid it to the dental office. In most cases we are not collecting the deductible/copayment twice (once by us and once by the dental office). If the provider collected the deductible/copayment from you, we note the deductible/copayment for our records and this is reflected on your EOB. Contact Ameritas if you feel an error has been made on your EOB.
Why are you paying the dental office? I already paid them. We pay according to how benefits are authorized on the claim form. If you sign the authorization field on the claim form, benefit payment is released to the dental office and we will pay benefits to your dental office. If you visit a network provider, benefits will be assigned to them per their contractual agreement. Contact Ameritas if you are being charged up front for the full amount of your services by a network provider.
Why did you pay me? Payment was supposed to go to the dental office. We pay according to how benefits are authorized on the claim form. If you sign the authorization field on the claim form, benefit payment is released to the dental office and we will pay benefits to your dental office.

Still having trouble?

Contact CASEBP at casebp@oncboces.org or (607) 588-8917 or Ameritas at group@ameritas.com or 1-800-659-5556.

Otsego Northern Catskills BOCES

Dental Coverage

General Dental Coverage Information

How to Submit Claims

Plan Documents

Dental Enrollment Forms

Who to Contact?

Frequently Asked Questions