Dental--California

	Carpenters Southwest Administrative Corporation
	California Dental Click here for a summary of the dental plan benefits.
		Effective August 1, 2009, Liberty Dental (LDP5 DHMO Plan) provides you with comprehensive dental coverage without claim forms, deductibles, or annual maximum limitations. Liberty Dental Plan contracts with quality dental professionals to provide services to you and your eligible dependents at no cost or low fixed co-payments. To visit Liberty Dental, click here. Click here for Liberty Dental information. Click here of the Schedule of Benefits. Click here for a Liberty Dental Plan Enrollment form . IMPORTANT! THIS FORM MUST BE SUBMITTED TO CARPENTERS ADMINISTRATIVE OFFICE, NOT TO Liberty Dental Plan . Click here for a list of Liberty Dental Plan providers.
		Golden West Dental (Plan 89L3) is a Dental Maintenance Organization (DMO), which contracts with selected dentist. You must select a dentist and orthodontic at the time of enrollment from their Participating Provider Network. Each participating dental facility listed in the directory is listed with a symbol or number and may be limited to the plans they accept. Please choose carefully and be sure to use the CODE number to identify your selection on the Enrollment Form. For more information please call toll free 1-800 995-4124 or click here to log on to their website For a directory of Golden West providers in California, click here. For a summary of Golden West plan info, click here. For the Golden West fee schedule, click here. In Spanish, click here. For the Golden West Frequently Asked Questions list, click here. In Spanish, click here. Click here for a Golden West Enrollment form. IMPORTANT! THIS FORM MUST BE SUBMITTED TO CARPENTERS ADMINISTRATIVE OFFICE, NOT TO Golden West . Click here for the Golden West Enrollment form in Spanish. IMPORTANT! THIS FORM MUST BE SUBMITTED TO CARPENTERS ADMINISTRATIVE OFFICE, NOT TO Golden West . Click here for a Golden West Change form. IMPORTANT! THIS FORM MUST BE SUBMITTED TO CARPENTERS ADMINISTRATIVE OFFICE, NOT TO Golden West .
		Pacific Union Dental (Carmel 600 Plan) is a Dental Maintenance Organization (DMO) which contracts with selected dentist. You must select any dentist from their Participating Provider Directory. For more information please call (800) 999-3367. Click here to view or print PUD’s Schedule of Benefits Click here to view or print PUD's Ortho, limitations, and exclusions booklet. Click here to view or print the Southern California PUD Directory. Click here to view or print the Northern California PUD Directory. Click here for a PUD Enrolllment/Change form. IMPORTANT! THIS FORM MUST BE SUBMITTED TO CARPENTERS ADMINISTRATIVE OFFICE, NOT TO PUD.
		Effective January 1, 2008, DeltaCare® USA --Plan 11A -- (administered by Delta Dental of California) provides you and your family with quality dental benefits at an affordable cost. The DeltaCare USA program is designed to encourage you and your family to visit the dentist regularly to maintain your dental health. When you enroll, you select a contract dentist to provide services. The DeltaCare USA network consists of private practice dental facilities that have been carefully screened for quality. Visit Delta’s website for a listing of providers at www.deltadentalca.org. Click here for a DeltaCare USA Enrolllment/Change form. IMPORTANT! THIS FORM MUST BE SUBMITTED TO CARPENTERS ADMINISTRATIVE OFFICE, NOT TO DeltaCare USA. Click here for the DeltaCare USA plan details. For a list of southern California dental offices, click here. For a list of northern California dental offices, click here.
		Fee-for-Service All new or reinstated eligibles must enroll in a DMO plan when they reside inside a DMO service area. Benefits are paid according to a schedule (See SPD for Dental Schedule) The difference between what your provider charges and the amount paid according to the schedule will be your responsibility Preauthorization is recommended for any services over $500 Maximum we pay per calendar year is $1500 per family member Obtain a dental claim form from the Fund Office or click here to print a form and send an itemized bill directly to: Southwest Carpenters Dental Claims PO Box 659444 San Antonio, TX 78265 In some areas, the Trust maintains a panel of dentists that have agreed to accept the Plan’s dental allowances as payment in full (excludes orthodontic and lab fees). For a list of the Fee-for-Service Dental Panel dentists, please click here. For the Fee-for-Service Dental Allowances, please click here.

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