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Legal Notices | ADA Members Insurance Plans – Insurance for Dentists and Their Practices

Legal Notices

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 by Great-West.

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 ada@greatwest.com. We will honor your request without question.

Money-Back Guarantee

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 ada@greatwest.com.

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 claims procedures.

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.

Certificates

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 money-back guarantee.

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.

Eligibility

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.

Definitions

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."

Attained Age

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.

Long-Term Renewability

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 or amendment.

Premium Credit

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 ada@greatwest.com.

Dentists:This website is not a contract. Benefits are provided under respective Group Policy Nos. (104TLP Annually Renewable Term Life, 1105GDH-IPP Disability Income Protection, 1106GDH-OEP Office Overhead Expense Disability, 104GUL Universal Life, 104LTLP Level Term Life, 1117GH-HIP Hospital Indemnity, 1127GH-CIP Critical Illness, and 1107GH-MCP MedCASHSM) filed in the State of Illinois in accordance with and governed by Illinois law, issued to the American Dental Association, and underwritten by Great-West Financial®. All ADA-sponsored coverage is subject to underwriting and is not guaranteed issue unless specifically stated otherwise. Coverage that is guaranteed issue is subject to a pre-existing condition limitation. The ADA is entitled to receive royalties from the ADA Members Insurance Plans. Coverage is available to all eligible ADA members and student members in all fifty states and U.S. territories under the aforementioned group policy. Level Term Life premiums are fixed based on the selected duration of 10 or 20 years. Must maintain membership throughout selected term. Annually Renewable Term Life, Hospital Indemnity, Critical Illness, and MedCASH premiums increase annually based on age. Recommended premiums under the Term Plus® Universal Life plan consist of the cost of insurance (which may vary based on the member’s age and coverage amount), the amount chosen by the member for deposit into his/her Policy Value Account and a service charge. Premium deposits may fluctuate or remain level depending upon the amount maintained in the Policy Value Account. Disability Income Protection premiums increase every 5 years and Office Overhead Expense every 10 years based on age. Premium credit for Annually Renewable Term Life and Term Plus Universal Life is not guaranteed but reevaluated annually. Premium credit for Disability Income Protection, Office Overhead Expense, Hospital Indemnity, Critical Illness, and MedCASH is not guaranteed but reevaluated semi-annually. Each Plan participant will receive a Certificate of Insurance explaining the terms and conditions of the policy.


Dental Students: This website is not a contract. Student coverage is issued regardless of your condition if you are under 45. If you are 45 or older, you can apply for the no-cost coverage and all student program features by providing proof of good health. Coverage renews automatically each academic year. Individuals may convert coverage to the plans for practicing dentists after graduation by paying ADA member premiums and maintaining ADA membership. Benefits are provided through a group policy Nos. (104TLP Term Life and 1108GDH-SDP Student Disability) filed in the State of Illinois in accordance with and governed by Illinois law, issued to the American Dental Association, and underwritten by Great-West Financial®. All ADA-sponsored coverage is subject to underwriting and is not guaranteed issue unless specifically stated otherwise. Coverage that is guaranteed issue is subject to a pre-existing condition limitation. Coverage is available to eligible ADA members and student members in all fifty states and US territories under the aforementioned group policy. Each insured will receive a certificate of insurance explaining the terms and conditions of the policy.


ADA® is a registered trademark of the American Dental Association and Great-West Financial® is a registered trademark of GWL&A.


Great-West Financial® refers to products and services provided by Great-West Life & Annuity Insurance Company, Greenwood Village, CO, its subsidiaries and affiliates. GWL&A is not licensed in New York, but eligible members residing in New York may request and ultimately receive coverage under the aforementioned group policy. The trademarks, logos, service marks, and design elements used are owned by Great-West Life & Annuity Insurance Company. ©2017 Great-West Life & Annuity Insurance Company. All Rights Reserved. For website issues, contact the Webmaster at ADA_WebMaster@greatwest.com.

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