Dental--Northern Nevada

	Carpenters Southwest Administrative Corporation
	Northern Nevada Dental Click here for a summary of the dental plan benefits.
	You must complete an enrollment form/card for the plan you elect for you and your dependents to be covered for dental benefits.
		Effective January 1, 2008, DeltaCare® USA --Plan 11 A -- (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 Nevada dental offices, click here.
		Effective August 1, 2009, Liberty Dental (NV-7 EPO Plan) provides you with comprehensive dental coverage without provider assignment, claim forms, deductibles, or annual maximum limitations as long as you use Liberty’s network of providers. 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. .
		Nevada Pacific Dental --- a United Healthcare Company (Freedom Affinity 110 Plan) (ID card is provided by NPD) In-Network: You must use a Panel Provider No Annual Deductible No Plan Maximum Lower Co-Payments Out-of-Network: You can go to any provider you choose $50 Annual Deductible $1,000 Annual Plan Maximum Payment based on a Flat Fee Schedule For NPD Customer Service, call (800) 926-0925. Click here for a NPD Enrolllment/Change form. IMPORTANT! THIS FORM MUST BE SUBMITTED TO CARPENTERS ADMINISTRATIVE OFFICE, NOT TO NPD. Click here to view the NPD schedule of benefits. Click here to view or to print the list of participating dentists.
		Fee-for-Service FEE FOR SERVICE DENTAL – (Go to any dentist you choose) (ID card is provided by Southwest Carpenters) You may go to any dental provider you choose 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 and send an itemized bill directly to the Trust to: P.O. Box 17973 Los Angeles, CA 90017-0973 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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