Frequently Asked Questions

PPO Advantage

Q: How many times a year can I have my teeth cleaned?
Two cleanings within a 12 month period.
Q: What is a pre-existing condition? Is it covered?
A pre-existing condition is an oral health condition, which existed before your enrollment in a dental program. The policy does not include an exclusion for pre-existing conditions.
Q: What is work in progress? Is it covered?
Work in progress is any oral health procedure that is started and not completed prior to your enrollment in a dental program. The policy does not cover any expenses prior to the date you are covered under the Policy.
Q: Are cosmetic procedures covered? If so, what procedures?
Although cosmetic procedures are not covered by the plan, all procedures, including cosmetic procedures, are provided at a discounted rate when services are obtained from a Network provider.
Q: Is Orthodontia Covered?
Although orthodontic procedures are not covered by the plan, all procedures, including orthodontic procedures, are provided at a discounted rate when services are obtained from a Network provider.
Q: Do I need to obtain claim forms?
Most providers use an industry-accepted form for submission to an insurance carrier. In the event your provider asks for a claim form, please contact member services.
Q: Is this insurance?
Yes, this is a dental insurance plan offered through Nationwide Multiflex Dental.
Q: Can I change my dentist once I am in the plan?
Yes, you may change your dentist at any time.
Q: When will I receive my membership package and what will it include?
You will receive your enrollment package via email within 10 days of approval of your application. The email will contain the web address to go to, along with a username and password to log in and retrieve your enrollment package. It will include a welcome letter, policy, certificate and ID card.
Q: How long does it take to process my application?
Your application will be processed within 5 days of receipt.
Q: If I choose to pay by credit card, what will my credit card statement read?
When paying by credit card, your statement will read "Merchants Benefit Administration."
Q: If I choose to pay by Bank Account Draft (ACH), what will my bank statement read?
In most cases, the transaction field on your statement will read "Merchants Benefit Administration".
Q: Do the applicant name and billing name need to be the same?
No, the applicant name and the billing name do not need to be the same.
Q: What if I need to change my membership from Individual to Family Coverage?
Contact member services to add or cancel coverage for a dependent.
Q: How do I add or cancel coverage for a dependent?
Contact member services to add or cancel coverage for a dependent.
Q: If I cancel the policy, will I receive a refund of the premium?
You will only receive a refund of the premium, if cancelled within the first 30 days of enrollment. The $6 Admin Fee and $1 NSBA Fee are non-refundable.