UFCW Local 1776 Benefit Funds
Dental Benefit
Dental Program
The dental benefit promotes dental health by providing comprehensive coverage for diagnostic and preventive care. The dental benefit also provides coverage for restorative care (fillings), periodontics (gum treatments), endodontics (root canal), orthodontics (braces) and oral surgery. You, your spouse and your dependent children may be eligible for the dental benefit under the Fund.​
Filing a Claim
At the appointment, ask your dentist for an itemized statement identifying the services you received and a receipt showing proof of payment. You or your dentist must submit a claim (using the American Dental Association approved claim form) and proof of payment to the Fund Office in order to receive reimbursement according to the Fund allowance for the services. Upon receipt of the completed claim form, the Plan will pay the allowance either to you (if you submit proof of payment) or to your dentist (if you submit an assignment of benefits with the claim).
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Important: All claims must be filed no later than one year from the date of service in order to be considered for payment.
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These procedures for filing claims apply to services provided by a primary care dentist or a dental specialist.