Group Dental Insurance

Group Dental

The Dental program will help defray the costs of dental treatment if an insured
person is :
seeking dental treatment at a registered Dentist in Singapore
for the services listed in the Schedule of Benefits

Basis of Benefits
Contract Staff are covered
All Employees and their Eligible Dependants
Dependants :
Legal Spouse and spouse with a dependant pass, below age 65
Each Child at least 2 weeks old and under 19 years of age and unmarried,
extended up to age 25 if full time student, unmarried and dependent upon
Insured employee for support.

MERCER 31
Group Dental
What are the benefits?

Plan 1
Panel Dentist As charged
(according to schedule of allowances)
Non-panel Dentist Sub-limits
(according to schedule of allowances)

NOTE:
Replacement of lost card costs S$10 per card.

MERCER 32
Group Dental
Benefits
Visit to Panel dentist for dental services listed in Schedule of Allowances
Unlimited visits & Cashless (upon presentation of card)
No pre-existing condition exclusion
No annual claim limits
Comprehensive dental coverage including :
Fillings,
Simple & surgical extractions,
Scaling & polishing,
Fluoride treatments
Root Canal treatments
Excision of tumours
Jaw fractures
Wisdom tooth extractions
Visit to Non Panel Dentist for dental services listed in Schedule of Allowances
Reimbursement up to max. limits as per Schedule of Allowances

MERCER 33
Group Dental
Schedule of Allowances
Panel Non-Panel
1 EXAMINATION
Initial (no more than one in every six consecutive months) As Charged 15
2 X-Ray
Intraoral As Charged 12
Bitewing As Charged 12
Panorex As Charged 32
3 TEST & LABORATORY
Biopsy and examination of tissue As Charged 48
4 PROPHYLAXIS
Routine As Charged 40
Complex As Charged 60
5 FILLINGS (SILVER) - for posterior teeth only
Amalgam - one surface As Charged 16
Amalgam - two surfaces As Charged 24
Amalgam - three or more surfaces As Charged 32
Reinforced Pin As Charged 9
6 FILLINGS (TOOTH-COLOURED MATERIAL )
- for anterior teeth and buccal (one surface) filling of premolars only
One surface As Charged 30
Two surfaces As Charged 40
Three surfaces As Charged 50
7 PULPOTOMY
Pulpotomy As Charged 40
Pulp Cap As Charged 20
8 ROOT CANAL TREATMENT
Single root canal filling As Charged 150
Double root canal filling As Charged 220
Three or more canals As Charged 350
X-ray of the tooth involved with the diagnostics wire or wires in place
must accompany claim for payment
MERCER 34
Group Dental
Schedule of Allowances

9 EXTRACTIONS
Routine (simple) - each tooth As Charged 30
10 SURGICAL EXTRACTIONS
Erupted tooth or root As Charged 120
Soft tissue impaction As Charged 160
Part bony impaction As Charged 250
Completely bony impaction As Charged 320
X-ray of the tooth or root involved must accompany claim for payment
11 ALVEOPLASTY
Per quadrant, in connection with extractions As Charged 30
Per quadrant, not in connection with extractions As Charged 42
For a complete Alveoplasty involving more than one quadrant As Charged 160
12 EXCISION OF TUMOUR
Excision of tumour As Charged 76
13 FRACTURE OF JAW
Simple As Charged 500
Compound As Charged 600
X-ray of the fractune must accompany claim for payment
14 REPAIR OF PROSTHETIC APPLIANCE
Repair of broken complete or partial denture As Charged 20
Repair denture and replace broken tooth As Charged 40
Adding tooth to partial denture to replace extracted tooth As Charged 24
Add tooth to partial denture plus clasp As Charged 54
15 SPACE MAINTAINERS
Fixed band type (uni or bilateral) As Charged 135
Removal in acrylic (uni or bilateral) As Charged 67

MERCER 35
Group Dental
What are not covered?

Dental procedures not included in Schedule of Allowances

Any hospital charges
Injuries arising directly or indirectly, wholly or partly from war, declared or
undeclared, revolutions or any warlike operations
Any form of medicine
Braces and dentures
Specialist charges

MERCER 36
Claims Procedures
for Dental
Dental Claims Procedure

NO Is Clinic on YES
AIA's Panel ?

Claimant to bring Dental Claim Claimant to present Dental card to clinic at

form to clinic for them to time of registration.
complete and to settle bills first. Claimant need to pay cash for items not
Send claim form & bills to Mercer covered
within 20 days of visit.

Clinic will bill AIA for

Payable by YES payment
AIA?

NO
AIA will forward declination AIA will GIRO payment
notice to Mercer to Member's bank

Mercer to send payment

worksheet /declination
notice to employees

All claims forms are batched and sent to Mercer every Friday morning.
MERCER 38