This website is an outline only and not a contract. Benefits provided under respective Group
Policy Nos. (104TLP Annually Renewable Term Life, 1105GDH-IPP Income Protection, 1106GDH-OEP Office Overhead Expense,
104GUL Universal Life, 1127GH-CI Critical Illness, 1117GH-HI Hospital Indemnity, and 1107GH-MCP MedCASHSM) issued to the
American Dental Association; insured by Great-West Financial
and filed in accordance with and governed by Illinois law. Coverage available to all eligible ADA members residing in any U.S.
state or territory. Term Life and MedCASH premiums increase annually, Income Protection every 5 years and Office Overhead
Expense every 10 years. Annual Universal Life premiums may fluctuate or remain level depending upon the amount maintained
in the Policy Value Account. Premium Credit discount not guaranteed but reevaluated annually.
All ADA-sponsored policies are subject to underwriting and are not guaranteed issue
unless specifically stated otherwise. Coverage that is subject to underwriting is
not effective until the date the application is approved by Great-West. Coverage
that is guaranteed issue is not effective until the date the application is received
Privacy and Confidentiality
Great-West respects your privacy and treats your personal information (including
medical records) with complete confidentiality. We do not share your name, account
history, or coverage status with anyone unless we receive your prior written request.
When we communicate with you via fax, we make every effort to indicate the nature
of our correspondence on the cover page so you can protect your privacy. However,
if you request materials to be faxed to your office, we cannot guarantee confidentiality
for the transmission on your end. We will honor your preferences for fax, email,
phone, or mail communication to the extent possible.
Your rights to privacy under the Health Insurance Portability and Accountability
Act of 1996 (HIPAA) affect our administration of the ADA-sponsored MedCASHSM Plan. Our HIPAA compliance measures ensure
that your personal health information (PHI) is protected at all times. Click here
for our Notice of Privacy Practices.
Your ADA membership information is provided to Great-West by the ADA so that we
can inform you directly about the group insurance available to you as a benefit
of ADA membership. Mailings include notices of product changes and enhancements,
the availability of new or additional coverage, and notices of upcoming events (such
as our activities at the ADA Annual Meeting). If you wish to be removed from our
mailing list, please contact us at 800-568-2001 or email@example.com.
We will honor your request without question.
When you purchase insurance coverage through the ADA Members Insurance Plans, your satisfaction
is guaranteed. You may discontinue your coverage at any time within the first 30
days and receive a full refund of all premiums paid.
Each approved Plan participant will receive a Certificate of Insurance explaining
the terms and conditions of the appropriate policy. Should you have any questions
about any provision at any time, you can contact us at 800-568-2001 or
Your Rights and Responsibilities
As an applicant or customer, you have the right to courteous and professional service,
personal attention, and quality insurance protection. We appreciate your business
and are grateful for the opportunity to serve you.
When you apply for coverage or submit a claim, it is your responsibility to provide
us, as requested, with thorough and accurate information about your medical history,
financial status, and any other condition that may affect your insurability or eligibility
for benefits. Your cooperation will help expedite our administrative processes and
provide you with a faster decision.
You have the right to appeal certain claims decisions according to guidelines established
jointly by the ADA and Great-West. The appeals process is outlined in the Certificate
of Insurance provided to each approved Plan participant. Click here for more information
on our underwriting or
As a Plan participant, you also have the right to renew the same coverage you have at
the time of renewal, subject to
the terms of your Plan, without further medical or financial underwriting. By paying
your renewal premium, you are attesting that you meet the eligibility requirements
to continue your insurance under that Plan. Your coverage is subject to the terms
and conditions of the Plan at all times, as outlined in your Certificate of Insurance.
Replacement of Existing Insurance
Our philosophy is to help you obtain and maintain adequate and appropriate insurance
protection. When considering your insurance options, it may not be wise to replace
an existing insurance policy — especially if your health has deteriorated or if
you cannot secure comparable coverage. In such cases, ADA-sponsored insurance may
be an excellent choice to supplement, rather than replace, existing coverage.
If you do decide to replace your current coverage, we strongly recommend you wait
for written approval of the replacement policy before canceling or reducing coverage
under any existing policy. In addition, we encourage you to carefully compare policy
provisions before making any decisions.
A Certificate of Insurance is mailed to every approved participant after the first
premium is paid. Your individual Certificate will be customized depending on the
optional features or coverage elected and the terms of underwriting approval. This
Certificate should be kept in a safe place with your other important documents.
You are strongly encouraged to thoroughly review your Certificate to become familiar
with the terms and provisions of your coverage under the group policy. If you are
not completely satisfied, you can take advantage of our
Please note: The ADA reserves the right to make changes to any sponsored insurance
Plan without notice, which would be fully described in a revised Certificate sent
to all participants.
All ADA members who are under age 60 can apply for coverage under any of the ADA
Insurance Plans (age 65 for Term Life). For some Plans, you must also be actively
working full-time to be eligible for coverage. In addition, your spouse or Domestic
Partner under age 60 (or 65 for Term Life) and your dependent children under age
21 (or age 27 for full-time students) may apply for life insurance and/or MedCASH
coverage as long as you apply for (or have already purchased) the same type of ADA
coverage. Note: If you apply for Domestic Partner coverage, you must also submit
an Affidavit of Domestic Partnership
signed by both parties. Upon termination of any Domestic Partnership, you will be
asked to complete a Termination
of Domestic Partnership in order to terminate the respective Domestic Partner
and/or dependent child coverage.
Coverage is continuously renewable, as allowable by Plan, as long as you pay premiums
when due, remain an ADA member in good standing, and satisfy all eligibility requirements.
(Under some Plans, for instance, you are required to be
Actively Working Full Time to continue your coverage.) By paying your renewal
premium, you are attesting that you meet all Plan-specific eligibility requirements
to continue your insurance under the Plan.
Proof of Insurability
Unless otherwise noted, proof of insurability is required when you apply for coverage
under the ADA Members Insurance Plans. Required medical and financial underwriting can begin
as soon as your application and supporting documentation is received by Great-West.
To help expedite the underwriting process, your cooperation and assistance is appreciated.
Click here for more information about our underwriting
procedures and requirements.
Termination of Master Policy
Great-West, the underwriter and administrator, cannot terminate any of the ADA Members Insurance
Plans master policies. In the unlikely event that the ADA terminates a policy and
does not offer a replacement plan, Great-West will continue the same coverage amount(s)
you held under the ADA group contract(s) with rates based on your age group, or
in the case of Term Life, allow conversion to an individual policy.
Actively Working Full Time
Working a minimum of 20 hours per week, performing all the substantial and material
duties of your occupation (usually either general dentistry or one of the specialties
recognized by the ADA). Planned absences of less than 60 days with a scheduled date
for your return to work do not affect your work status. Please note that in order
to be eligible for coverage and/or benefits under some Plans, you must satisfy this
definition of "Actively Working Full Time."
Your age for insurance purposes. Attained Age affects all aspects of your coverage,
including eligibility, renewability, and premiums. Your Attained Age will be the
same as your actual age beginning on the first day of the month following your birthday.
For example, if you turn 42 on October 18, 2004, then your Attained Age for insurance
purposes will change from 41 to 42 effective November 1, 2004. Note: When Attained
Age changes during a billing period, rates are proportionately blended.
Your ability to renew coverage, from one coverage period to the next, simply by
paying premiums and meeting all eligibility criteria. All coverage under the ADA
Insurance Plans is renewable for ADA members and their eligible dependents according
to the provisions of each group policy. Note: Coverage is subject to change as approved
by the ADA Council on Members Insurance and Retirement Programs. Changes will be
communicated to Member participants in the affected Plan via an updated Certificate
The Premium Credit is a Plan-specific discount that reduces billed premium for all
Plan participants, regardless of coverage amount. Premium Credits have been declared
by the ADA when a Plan's experience is favorable. Premium Credit discounts are not
guaranteed and may not be available on all Plans.
Great-West Financial makes every effort to ensure the accurate information is posted on this website.
However, in the event a system error results in the posting of inaccurate information, the accurate
information will control once the error is resolved.
Thank you for taking the time to read this important information. For further clarification,
please contact us at 800-568-2001 or firstname.lastname@example.org.