Carpenters Southwest Administrative Corporation

Utah

Dental

Click here for a summary of the dental plan 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 Utah dental offices, click here.

Total Dental Administrators Total Dental Administrators--Plan TC-6000 is a Dental Maintenance Organization (DMO), which contracts with selected dentist. You must select a dentist at the time of enrollment from their Participating Provider Directory.

Each participating dental facility listed in the directory has a Dental Office Code number listed.

Be sure to use the CODE number to identify your selection on the Enrollment Form. For more information please call (877) 725-8758 or click here to log on to their website. Use Plan TC 6000.

Click here for a TDA Enrolllment/Change form. IMPORTANT!  THIS FORM MUST BE SUBMITTED TO CARPENTERS ADMINISTRATIVE OFFICE, NOT TO TDA.

For a directory of TDA dentists, please click here.

For a copy of the Plan, please click here.

Fee-for-Service

All new or reinstated eligibles must enroll in a DMO plan when they reside outside a DMO service area until the next schedules open enrollment period.

  • 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.