CLAIMS PROCEDURE
Dental Care
The member may submit claims to the Plan Administrator, Johnson Inc ., at any time up to the end of the calendar year following the year in which the
expense was incurred . All claims are paid based on the date the expense was incurred .
For all dental care benefits, when the member’s insurance terminates for any reason, written proof of claim must be submitted to the Plan Administrator, Johnson Inc ., within 90 days of the date of termination of insurance .
Claim forms are available at the dentist’s office . When dental expenses are incurred, dentists must complete their portion of the form . The insured
completes their portion and returns it to the Plan Administrator, Johnson Inc ., for payment of eligible expenses . A direct pay option may be available at your dental office .