ORTHODONTIC CLAIMS 

The orthodontic treatment plan form only needs to be completed once and sent with the first orthodontic claim.  Each month thereafter, the employee should submit a regular claim form and a copy of an itemized statement showing the months charge for ortho treatment or a copy of the coupon booklet for the month if their doctor uses coupon books.  The ortho plan is initially set up with the information from the ortho plan form.

Once the orthodontic treatment is set in motion, reimbursements will only be made according to the original contract.  No variations from this contract are allowed.  For example - if your monthly payment is $100 and you decide to pay $200 one month, you will only be reimbursed based on the original $100 payment

Employees may call customer service with any claim question.

The number is 1-888-745-3274.