Answers to FAQ

How can I apply for insurance?

It's quick and easy to request insurance through the ADA Insurance Plans. Simply complete and sign the appropriate application form in writing, then return it to Great-West Life.

You can download an application or call 866-607-5338 to get the appropriate application(s) faxed, mailed, or e-mailed to you. Because your application will eventually become part of your insurance contract, it must be completed in full and include your signature before it can be processed.

All ADA Members in good standing and under age 60 (under age 65 for Term Life or Term Plus) are eligible to apply for new or increased coverage under the ADA Insurance Plans. The Member's Spouse or Domestic Partner and all eligible dependent children (under age 21, unless full-time students) are also eligible for coverage under some Plans.

How can I increase my coverage?

To add more insurance under any ADA Insurance Plan, you must complete an application and return it to Great-West Life by fax or mail. Downloadable applications are available online. You can also call 866-607-5338 to request additional assistance determining your insurance needs.

To be eligible for additional coverage, you must be under age 60 (under age 65 for the Term Life or Term Plus Plans) at the time of application. Certain other eligibility requirements will also apply to some Plans, and proof of insurability is required under most Plans.

What is Proof of Insurability?

"Proof of insurability" refers to the written evidence that verifies you are insurable according to the general underwriting standards of the insurance company. Your proof of insurability is generally determined through medical and/or financial underwriting. Please note: Medical underwriting typically involves a paramedical exam (which is arranged at your convenience and at the Plan's expense), blood draw, and a report from your attending physician.

Insurance companies routinely gather information about applicants in order to evaluate each individual who applies for coverage. Every ADA Member who requests coverage through the ADA Insurance Plans is individually underwritten. But once you have provided acceptable proof of insurability to initially qualify for coverage, you can continue that coverage as long as each Plan allows, no matter what happens to your medical condition and/or financial circumstances thereafter.

How long does it take to be approved?

It typically takes 8 - 12 weeks from the date your application is received until an underwriting decision can be made. However, application processing time can vary depending on the type and amount of coverage requested and the timely availability of your personal information.

You can make a big difference in helping reduce the time it takes to process your application. We appreciate your active involvement and cooperation, and we know you'll appreciate a decision as quickly and efficiently as possible, too. To expedite processing, please follow these pointers:

Make sure your application is thoroughly completed — with all questions answered and all signatures provided — when you first submit it.
Schedule your paramedical exam as soon as possible, then keep your appointment.
Notify your physician's office so they can begin assembling copies of your medical records.
Submit copies of all required federal income tax returns and financial or legal documents along with your application. Financial underwriting requirements and an affidavit of Domestic Partnership (if you are requesting coverage for your Domestic Partner) are available online.

Please note: If you need proof of insurance specifically to provide collateral for a loan, please plan ahead. We will do our best to expedite your application internally, and can even provide your lender with documentation to support the loan approval process.

If I have health problems, can I still get coverage?

Perhaps. Your ability to be approved for coverage will depend on the nature and severity of your medical impairment(s) and the type of coverage you're requesting. Some health problems that may not affect your insurability for one type of coverage could prevent you from acquiring another type of coverage. Regarding disability insurance, you may be offered coverage excluding a certain illness or condition, rather than being declined altogether. Because everyone's circumstances are different, contact a Plan Specialist at 866-607-5338 or ada@gwl.com to discuss your health concerns and personal situation.

Can I apply for coverage online?

You can download an application, which you can print out, complete, sign, and then mail or fax to Great-West Life. Applying online is not available at this time.

How does HIPAA affect my ADA insurance coverage?

Regulations based on the Health Insurance Portability and Accountability Act of 1996 (HIPAA) apply specifically to the administration of health plans. The MedCASH^SM Plan is the only ADA-sponsored insurance Plan for which HIPAA compliance is relevant. Protected health information (PHI) that you share with Great-West Life when applying for any other insurance coverage is not subject to HIPAA regulation, but we treat all your PHI with confidentiality in accordance with our stated privacy practices.

Basic coverage under the ADA MedCASH Plan is guaranteed regardless of your medical history or condition (and without the exchange of PHI). However, some PHI is required if you apply for optional MedCASH coverage. In that case, Great-West Life will request your authorization prior to reviewing and using your PHI. After receiving your HIPAA authorization, your approval for optional MedCASH coverage will be based on your responses to a brief medical questionnaire.

How do I apply for Spouse or Child coverage?

Your Spouse or Domestic Partner under age 60 (under age 65 for Term Life) and/or dependent children under age 21 (or age 23 if they are full-time students) are eligible for two types of ADA-sponsored coverage — life insurance under the ADA Term Life Plan, and supplemental medical insurance under the ADA MedCASH Plan — as long as you are a participant in the same Plan and are eligible to apply for additional coverage.

You apply for dependent coverage on behalf of your family member(s), using the same application form you would use for Member insurance. Click here for a Term Life application or a MedCASH application.

When you apply for coverage for your spouse or Domestic Partner, he or she will be asked to provide proof of good health as required by the Plan. Both of you must also complete and sign the application. If you request coverage for a Domestic Partner, 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 form in order to terminate this coverage.

When can dental students apply for coverage?

If you are a full-time dental student and an ASDA member, you can apply for ADA Term Life or ADA Student Disability coverage anytime before May 1 of your graduation year. Coverage under both Plans is guaranteed without a medical exam or any other proof of insurability as long as you are under age 40 at time of application. (For students age 40 or older, proof of insurability will be required.)

Under the ADA Term Life Plan, you can enroll for $50,000 of life insurance and $50,000 of Accidental Death coverage (which both double to $100,000 on July 1 of your graduation year). This coverage is available at no cost to you through December 31 of your graduation year. Additional coverage is available at any time if fully underwritten and paid for by you; you can request up to $500,000 in Term Life coverage (including the free coverage) during the first three years of dental school, and up to the Plan's maximum of $2,000,000 in the calendar year of graduation. Coverage for your spouse or dependent children is also available at any time.

Under the ADA Student Disability Plan, you may choose either $1,000 or $2,000 of monthly coverage. If you were to become totally disabled and unable to perform the normal duties of a full-time dental student, benefits may be received for up to two years. (Under this plan, benefit eligibility begins after just 90 days of disability.) You can then receive benefits for an additional five years if you cannot perform the duties of any occupation for which you are qualified. Monthly benefits may be used to help cover living expenses, pay down debt or train for another career. You may even qualify for student loan repayment depending on the length and severity of disability.

What if I am not satisfied with my coverage once it is issued?

After you're approved for coverage and have paid the required premium, you will receive an individual Certificate of Insurance that details the coverage and options you elected. All ADA-sponsored coverage includes a 30-day money-back guarantee, so if you are not completely satisfied with the terms and provisions explained in your Certificate, you can request a full refund. Simply return your Certificate, along with a written request for termination, within the first 30 days of coverage.

How do I file a claim?

You can download a claim form or can call us at 800-568-2001 to request the appropriate form(s). Once you've obtained the form, simply complete and sign it, then submit it to Great-West Life via fax or mail. (For your protection, we ask that all claims are made in writing.) Additional documents, such as tax records, monthly P&L statements, medical records, or a death certificate, will be required depending on the type of claim.

Your claim will be reviewed as quickly as possible by one of our experienced Claims Consultants. If you have questions about completing the form or the claims process in general, contact us at 800-568-2001 or ada@gwl.com.

How long will it take before I receive benefits?

Most life insurance claims are processed very quickly, pending receipt of all necessary documentation (which includes a death certificate for life insurance claims). We make every attempt to issue benefit checks to beneficiaries within 10 business days after we receive all required information. Please allow a few extra days for your check to reach you via standard U.S. mail.

For disability claims, the review process can take up to several weeks or longer, depending primarily on the timely receipt of critical information from both you and your physician. Your physician's report and clinical records, along with any required financial records for you and/or your practice, must be reviewed before a check can be issued. Your assistance in obtaining clinical information from your physician(s) and in providing necessary financial documentation can make a big difference in speeding the process along. Please note: You must also satisfy your waiting period before becoming eligible for disability benefits.

For claims under the ADA MedCASH Plan, benefits can be paid as soon as your claim is filed and you satisfy the required waiting period (if any). Hospital Coverage benefit checks are typically issued within a week after you have submitted a photocopy of your actual hospital bill (please note that your health insurer's EOB (explanation of benefits) statement does not provide us with all the information we need to process your claim). Critical Condition benefit checks are issued as soon as the appropriate survival period and waiting period have been satisfied, following the receipt of all necessary documentation. Receipt of your medical records is required for Critical Condition benefits; in particular, your physician will need to provide a confirming clinical diagnosis of your qualifying condition before benefits can be paid.

Who can file a claim?

For Income Protection, Office Overhead Expense, and MedCASH claims, and for Disability Waiver of Premium claims under Term Life and Term Plus, the ADA Member who is the primary certificateholder must file the claim, even if the claim pertains to a spouse or dependent child. For Term Life or Term Plus claims where the member is deceased, the member's spouse or other named beneficiary, or an executor, must file the claim.

Do you reduce disability benefits if I earn income outside of dentistry while I'm disabled?

No. Whether you are capable of earning income from other occupations (like teaching, consulting, or sales) or simply choose to work as a way to stay mentally or physically active, your monthly disability income benefits will not be reduced because of income earned from another occupation. In fact, the ADA Income Protection Plan was recently enhanced so members can now receive full benefits regardless of any other income they choose to earn while disabled from dentistry. As a result, as long as you earn less than 20% of your pre-disability income from clinical dentistry (whether totally or partially disabled), you can be eligible for your full monthly benefit amount. This change illustrates the ADA's ongoing commitment to providing generous insurance protection and great overall value to members.

Why do I need to provide a clinical diagnosis for my hospital claims under the MedCASH Plan?

According to the Plan's provisions, benefits are payable for each medically necessary day of hospital confinement. A diagnosis from the hospital is the easiest way of verifying medical necessity so that your claim can be paid as quickly as possible.

For my MedCASH claim, can I submit an explanation of benefits statement in lieu of a hospital bill?

No. Your hospital bill includes specific information needed to process your claim, which does not appear on your health insurer's EOB (explanation of benefits) statement. For example, your medical diagnosis and type of room are generally included on the hospital bill, which allows us to quickly verify medical necessity (required prior to paying any claim). Your hospital bill would also help us quickly determine whether you were confined in an ICU and therefore eligible for double benefits.

Is underwriting required to increase my coverage?

In most cases, proof of insurability will be required for any coverage increase.

You may be able to obtain incremental increases in disability coverage on a guaranteed issue basis under a future increase provision in the contract. This feature is built into the ADA Office Overhead Expense Plan and is available as a coverage option for the ADA Income Protection Plan. Under such provisions, increases can be exercised at a renewal date without underwriting. Certain restrictions may apply, and your billing notice will indicate your eligibility for any guaranteed issue increase.

How can I increase my coverage?

To add more insurance under any ADA Insurance Plan, you must complete an application and return it to Great-West Life by fax or mail. Downloadable applications are available online, or you can call 866-607-5338 for help determining your insurance needs.

Depending on your insurance Plan, you may also be able to augment your existing insurance by adding various Plan-specific optional coverage(s) such as guaranteed future increases, Accidental Death coverage, Residual Plus disability coverage, or cost-of-living adjustment (COLA). Please note that there are age restrictions for electing and/or exercising each option, and not all options are available on all Plans. Consult your Certificate or contact us at 800-568-2001 for details.

To be eligible for additional coverage, you must be under age 60 at the time of application (under age 65 for Term Life or Term Plus). Certain other eligibility requirements will also apply to some Plans, and proof of insurability is required under most Plans.

When can I increase my coverage?

You can apply for more insurance, for yourself or for any eligible dependents, any time before you reach age 60 (or before age 65 for Term Life or Term Plus coverage). However, any time there is a major change in your financial situation or personal circumstances (such as a new home or baby, practice expansion, or child in college), you should re-evaluate and probably increase your insurance coverage. Also, if you meet with your accountant, attorney, or financial planner on an annual basis to discuss your overall finances, it's a good practice to include a review of your insurance situation.

Note: If there is a guaranteed future increase feature on your disability contract, you can automatically increase your coverage — without providing further proof of insurability — at certain policy renewal dates. You will be notified on your billing notice if you're eligible for such an increase, and all you need to do is pay the amount indicated. Your higher coverage will go into effect on the next premium due date.

What makes the ADA Insurance Plans different from other insurance?

As an ADA member, you benefit from group rates that reflect the ADA's volume buying power — volume that is supported by the largest professional organization for dentists in the world. Around 140,000 people (including ADA members, dental students, and their family members) rely on the ADA Insurance Plans for insurance protection each year.

All ADA-sponsored products are commission-free, meaning there are no sales commissions or royalty fees paid to anyone, including the ADA. In contrast, many state and local dental associations do profit from the sale of their endorsed insurance. Such coverage is typically priced accordingly to generate revenue for the endorsing organization. The absence of these fees on ADA-sponsored coverage helps keep your premiums low and competitive. In addition, special discounts can further reduce your net cost of insurance.

The ADA Insurance Plans have been protecting ADA members and their families since 1934. The long-term track record and relationship between the ADA and Great-West Life gives you confidence that your ADA-sponsored insurance protection will be there when you need it most.

What is the Accidental Death option?

Accidental Death coverage pays an extra benefit if your death results from an accident as defined by the Plan. When elected, the amount of your Accidental Death benefit is the same as your life insurance benefit, up to a maximum of $1,000,000. For example, if you have $400,000 of life insurance in force and purchase the Accidental Death option, your beneficiary would receive a total of $800,000 (i.e., $400,000 basic benefit + $400,000 Accidental Death benefit) if your death was by accidental means. On the other hand, if your life insurance coverage is $1,500,000, then your beneficiary would receive a total of $2,500,000 ($1,500,000 + $1,000,000) in the case of your accidental death.

You can elect this optional coverage for your ADA Term Life and/or Term Plus^® Universal Life coverage. Enhancing your life insurance coverage with the Accidental Death option can add tremendous value to your insurance protection. Please note: If you elect this coverage, any of your dependents who are insured in the Plan will automatically have this extra coverage too.

What is the Future Increase Option (FIO)?

The Future Increase Option (FIO), available on the ADA Income Protection Plan, enables you to increase coverage automatically without a medical exam. Increases of $500 per year, for a total of up to $2,500, can be exercised at renewal time (one per year for up to five years, subject to the Plan's current monthly maximum) by completing the documentation requested on your renewal notice and remitting the additional premium. This optional coverage feature may be requested until age 50 and exercised until age 55.

A similar feature is built into the ADA Office Overhead Plan. The Future Increase Benefit is exercisable at any renewal time before you turn 55, with mechanics similar to the Income Protection Plan: Increments are $500 each, for a total of up to $2,500 in additional monthly coverage (subject to the Plan's current monthly maximum). If you are eligible for an increase, you will be notified on your semi-annual renewal notice.

What is the Waiver of Premium option?

The Waiver of Premium feature allows your ADA life insurance coverage to continue, without paying premiums, if you become totally and permanently disabled (unable to perform any occupation) before age 60. Your coverage will continue at full value until it expires, which occurs at age 81 for the Term Life Plan, and age 90 for the Term Plus Plan. And if you have Term Life coverage in force for any of your dependents, premiums for that coverage will be waived too.

You can elect this optional coverage for your ADA Term Life and/or Term Plus Universal Life coverage. Enhancing your life insurance coverage with the Waiver of Premium option can add tremendous value to your insurance protection.

What does "Own Occupation" mean?

"Own occupation" is the basis used in defining disability coverage under the ADA Income Protection and Office Overhead Expense Plans. Own occupation coverage is the most generous type of disability insurance you can buy. It means that disability is determined by your inability to perform the duties of your specific occupation or profession. (If you are a practicing dentist performing clinical dentistry, then your occupation is the clinical practice of either general dentistry or one of the specialized areas of dental practice approved by the ADA, such as orthodontics or oral surgery.) That's important because your training and education have prepared you specifically for this profession, and if you can't practice dentistry because of a disability, you may be forced to change careers.

By contrast, "any occupation" disability coverage does not consider you disabled if you are still capable of performing the duties of any occupation for which you are reasonably suited, such as teaching, consulting, sales, or administration. If you purchase "any occupation" coverage, you may not receive any cash benefits even though you cannot physically tolerate the rigors of active dental practice.

Own occupation coverage can be difficult to find, and many insurance companies have eliminated or scaled back this type of coverage in recent years. But both ADA-sponsored disability insurance plans, the Income Protection Plan and the Office Overhead Expense Plan, automatically include own occupation coverage for all participants. In fact, under the Income Protection Plan, you can receive full own occupation benefits all the way to age 65, regardless of your age at time of disability, and regardless of any other income you choose to earn while disabled from dentistry. (Other policies may offer own occupation coverage for two or five years at most; after that point, an "any occupation" definition usually determines your eligibility to continue receiving benefits. Still other policies may offset, or reduce, the dollar amount of benefits you receive as a result of income you earn from other sources, like teaching or consulting.) Under the ADA Plan, full own occupation benefits can be payable all the way to age 65 (or for up to two years if you become totally disabled between ages 65 and 69) without any offsets for other income. And rates for ADA disability coverage can be significantly less than other disability insurance, even though the coverage may be much better.

If you're shopping around for the best disability insurance value, consider the impact that an own occupation definition could have on your potential to receive benefits. Dentists are uniquely prone to many types of physical disabilities, and most statistics show you have a 1 in 3 chance of becoming disabled at some point in your professional career. If your family's standard of living relies on your ability to earn income as a dentist, you may decide that it's well worth purchasing the most generous own occupation coverage available.

Do you reduce disability benefits if I earn income outside of dentistry while I'm disabled?

No. Whether you are capable of earning income from other occupations (like teaching, consulting, or sales) or simply choose to work as a way to stay mentally or physically active, your monthly disability income benefits will not be reduced because of income earned from another occupation. In fact, the ADA Income Protection Plan was recently enhanced so members can now receive full benefits regardless of any other income they choose to earn while disabled from dentistry. As a result, as long as you earn less than 20% of your pre-disability income from clinical dentistry (whether totally or partially disabled), you can be eligible for your full monthly benefit amount. This change illustrates the ADA's ongoing commitment to providing generous insurance protection and great overall value to members.

Do you offer major medical insurance?

No. The ADA does not sponsor any major medical coverage. Consult your local or state dental association for information on health plans available in your area.

However, you can get ADA-sponsored supplemental medical coverage that pays cash benefits no matter how much or what kind of other health insurance you have. Basic coverage under the ADA MedCASH Plan is available to eligible members and their dependents on a guaranteed issue basis, meaning no medical underwriting is required. Benefits can be used any way you like and are payable after hospital stays and ER visits, plus upon first diagnosis of one of 17 qualifying critical illnesses. Rates are extremely affordable, and higher, optional critical illness coverage is also available.

Do you offer Level Premium Term?

No. The ADA does not sponsor any level premium plan because it feels yearly renewable insurance is a better overall value for members. The ADA Term Life Plan, for example, is more suitably designed to provide the options and flexibility that meet dentists' long-term needs for quality, reliable life insurance protection at reasonable rates.

How does ADA Term Life insurance compare with Level Premium Term life insurance?

We're glad you asked! If you're trying to compare level premium life insurance with the ADA Term Life Plan, there are many important factors to consider. The most salient points are summarized in our Comparison Shopping guide.

Like the 100,000+ dentists and their family members who purchase ADA-sponsored life insurance, you may appreciate the flexibility and incremental rate structure that are built into ADA Term Life coverage. We invite you to investigate this further, because we're confident you'll agree that ADA Term Life may be a better option — and better overall value — for you and your family.

Do you have Own Occupation disability coverage?

Yes. Both of our disability policies, the ADA Income Protection Plan and the ADA Office Overhead Expense Plan, use an "own occupation" definition of disability to determine your eligibility for benefits. In fact, for the Income Protection Plan, own occupation coverage extends all the way to age 65 — meaning you could receive monthly disability benefits until age 65 if you can't practice dentistry due to disability.

Many disability policies don't provide long-term own occupation coverage anymore. And when you do find own occupation coverage, it often applies for a limited time only, such as the first two years of a qualifying disability. That's why the ADA-sponsored disability coverage is such an exceptional value: You get superior coverage for what is often a much lower price. We encourage you to compare policies and see for yourself.

How can I change my existing coverage?

You can modify many aspects of your insurance coverage at any time. Many administrative changes require your written authorization; some changes may also require proof of good health. Contact us for assistance, or select an option below. Simply print and complete the appropriate form, and then fax or mail your request to Great-West Life.

Add or change my beneficiary
Change my billing address
Change my insurance ownership
Change my billing frequency
Change my waiting period

If you're interested in more insurance, you can apply to increase your coverage any time before age 60 (before age 65 for the Term Life or Term Plus Plans). Rate quotes are available online, along with downloadable applications for additional insurance. Or you can contact a Plan Specialist at 866-607-5338 or ada@gwl.com for help tailoring your coverage to suit your needs and objectives.

When are premiums due?

Renewal premiums are billed either semi-annually or annually for life insurance Plans, based on the option you elect, and semi-annually for all other Plans. When you initially purchase coverage, you will receive an interim bill for the interim period until the next regular policy renewal date. You will subsequently be billed along with all other Plan participants according to your Plan's billing schedule. Billing notices may be mailed to any address you specify.

Premiums are billed about 30 days in advance of the renewal date, which provides ample time for you to remit payment by the due date. Delinquent payments received within 30 days after the renewal date will still be accepted, although coverage will go into lapse status on the 31st day after the due date and ultimately be terminated if payment is not received timely. To keep your coverage in force, please be sure to pay your premiums on time. Our reinstatement policy will apply if your coverage is terminated as a result of a late or absent payment.

Instead of receiving a billing notice through the mail, you can elect Autopay as a convenient, alternative billing option. Autopay enables you to pay premiums, either semi-annually or monthly, via pre-authorized automatic bank withdrawal. Your premiums are automatically deducted from your bank account, and your coverage renews automatically, too.

What should I do if I don't get a bill?

If you are expecting a bill but don't receive one, please contact us at 800-568-2001 or ada@gwl.com as soon as possible. You are still responsible for paying premiums when due. Your coverage must be renewed on time through full premium payment in order to stay in force. If your billing address has changed, please notify us as soon as possible.

Can I pay premiums over the phone?

Yes. Call 800-568-2001 to charge your premium to your credit card (MasterCard and Visa only). Your credit card payment can be processed Monday through Friday, 7:00 am to 5:00 pm Mountain Time. In an emergency situation, you may also be able to arrange for a one-time electronic transfer of funds via wire transfer to make premium payment. Anytime you elect to make a wire transfer, we ask that you call 800-568-2001 to obtain transfer information. Please note that your bank may charge a fee for wire transfers.

Can I pay premiums by credit card?

Yes. You can charge any insurance premium to your MasterCard or Visa account by calling 800-568-2001, Monday through Friday, 7:00 am to 5:00 pm Mountain Time. Whether you wish to get extra miles or points, defer payment for a while, or take advantage of the financial reporting/budgeting services provided through your credit card account, this premium payment option gives you greater flexibility. There is no additional cost to you to pay your premium by credit card.

If managing your cash flow is your ultimate goal, you may prefer to make smaller, more frequent premium payments via the monthly Autopay option. Offering you choices for premium payment, both in terms of renewal frequency and payment method, is another way we provide you with exceptional customer service. Learn more about your various payment options in our Service area, or by contacting us at 800-568-2001 or ada@gwl.com.

Can I pay premiums by automatic bank withdrawal?

Yes. Autopay allows your renewal premium to be automatically deducted from your bank account on a monthly or semi-annual basis for all Plans, and also on an annual basis for the Term Life Plan. Pre-authorization is required, but you can download an Autopay enrollment form and begin the process right away. Please note: A modest 2% charge applies to all monthly Autopay payments to help cover the costs of administering this payment option.

You can also pay premiums manually, after receiving your semi-annual or annual renewal notice, via any online bill-pay service such as that offered by your bank. In an emergency situation, you may also be able to arrange for a one-time electronic transfer of funds via wire transfer to make premium payment. Anytime you elect to make a wire transfer, we ask that you call 800-568-2001 to obtain transfer information. Please note that your bank may charge a fee for wire transfers. You can also contact us at 800-568-2001 or ada@gwl.com if you have any questions about electronic payment options.

How do Premium Credits work?

The Premium Credit is the distribution of Plan surplus that results from favorable recent Plan experience. When a Premium Credit is declared by the ADA, the current Premium Credit is applied in advance to reduce your premium at the time it is due. In fact, all Plan participants benefit from a Premium Credit discount, when applicable, regardless of age, coverage amount, or length of participation.

A Premium Credit automatically reduces your gross premium and is calculated before any other discount that may apply to your coverage. (Rates quoted include the current Premium Credit if applicable, but do not include other discounts.) While Premium Credits are not guaranteed, these discounts can dramatically reduce your cost of insurance. Returning Plan surpluses to participants is one more way the ADA ensures you get the best insurance value for your dollar.

How do volume discounts work?

Volume discounts of 5%, 7%, or 9% are based on the amount of member life insurance coverage you have purchased. Coverage in both the ADA Term Life Plan and ADA Term Plus^® Universal Life Plan counts toward your total, and if you qualify by having at least $500,000 of coverage, a volume discount will apply to whatever member and spouse life insurance coverage you have in force. If you qualify for a volume discount, it will automatically be deducted from your premium notice. Volume discounts are unlikely to change but are not guaranteed.

How can I get a rate quote?

You can get an Online Quote immediately, or you can get a more detailed illustration by contacting a Plan Specialist at 866-607-5338. Plan Specialists do not receive commissions, so they can help you objectively assess your various insurance needs and evaluate your coverage options.

What are your current rates?

Rates for each of the ADA Insurance Plans are available online. Simply click the appropriate Plan to display the current rate table for Term Life, Term Plus Universal Life, Income Protection, Office Overhead Expense, or MedCASH.

What is the current Premium Credit?

The Premium Credit, if applicable, varies by Plan because it involves the distribution of that Plan's surplus. A table of current Premium Credit values illustrates how significant these discounts can be. Please note that the current Premium Credit discount is declared at the time of policy renewal, either semi-annually or annually (depending on the Plan). Premium Credits are declared when a Plan's experience is favorable but they are not guaranteed.

How do Premium Credits work?

The Premium Credit is the distribution of Plan surplus that results from favorable recent Plan experience. When a Premium Credit is declared by the ADA, the current Premium Credit is applied in advance to reduce your premium at the time it is due. In fact, all Plan participants benefit from a Premium Credit discount, when applicable, regardless of age, coverage amount, or length of participation.

A Premium Credit automatically reduces your gross premium and is calculated before any other discount that may apply to your coverage. (Rates quoted include the current Premium Credit if applicable, but do not include other discounts.) While Premium Credits are not guaranteed, these discounts can dramatically reduce your cost of insurance. Returning Plan surpluses to participants is one more way the ADA ensures you get the best insurance value for your dollar.

What is the Accidental Death option?

Accidental Death coverage pays an extra benefit if your death results from an accident as defined by the Plan. When elected, the amount of your Accidental Death benefit is the same as your life insurance benefit, up to a maximum of $1,000,000. For example, if you have $400,000 of life insurance in force and purchase the Accidental Death option, your beneficiary would receive a total of $800,000 (i.e., $400,000 basic benefit + $400,000 Accidental Death benefit) if your death was by accidental means. On the other hand, if your life insurance coverage is $1,500,000, then your beneficiary would receive a total of $2,500,000 ($1,500,000 + $1,000,000) in the case of your accidental death.

You can elect this optional coverage for your ADA Term Life and/or Term Plus^® Universal Life coverage. Enhancing your life insurance coverage with the Accidental Death option can add tremendous value to your insurance protection. Please note: If you elect this coverage, your spouse and/or dependent children who are insured in the Plan will automatically have this extra coverage too.

What is COLA?

COLA is an acronym that represents the Cost of Living Adjustment option available on ADA Income Protection coverage. This "inflation fighter" option allows any disability income benefits you may receive to automatically increase over time to reflect the rising cost of living. Benefit increases are based on increases in the Consumer Price Index (CPI), which means your disability income can keep pace with inflation to help you continue covering your living expenses. See the premium rates for this coverage option, which can provide significant benefit increases if you become totally disabled.

You can elect the COLA option any time before age 50, either as a separate coverage enhancement or at the same time you apply for new or increased coverage. If you have purchased this extra coverage and are on claim, your benefit increases will take place annually after your first 12 months of total disability, and can continue, as long as you remain totally disabled, until you turn 65 or until your monthly benefit amount has doubled, whichever occurs first. Increases are compounded every year. For example, if your original monthly benefit is $6,000 and your first increase based on the current CPI is $100, your next increase will be based on $6,100, and so on.

What is the Future Increase Option (FIO)?

The Future Increase Option (FIO), available on the ADA Income Protection Plan, enables you to increase coverage automatically without a medical exam. Increases of $500 per year, for a total of up to $2,500, can be exercised at renewal time (one per year for up to five years, subject to the Plan's current monthly maximum) by completing the documentation requested on your renewal notice and remitting the additional premium. This optional coverage feature may be requested until age 50 and exercised until age 55.

A similar feature is built into the ADA Office Overhead Plan. The Future Increase Benefit is exercisable at any renewal time before you turn 55, with mechanics similar to the Income Protection Plan: Increments are $500 each, for a total of up to $2,500 in additional monthly coverage (subject to the Plan's current monthly maximum). If you are eligible for an increase, you will be notified on your semi-annual renewal notice.

What is Guaranteed Issue?

Insurance coverage that is guaranteed issue means no proof of insurability is required; as long as you meet all eligibility requirements, you are guaranteed to get the coverage — no questions asked — regardless of your medical or financial situation. Guaranteed issue coverage is most frequently offered in small amounts for a limited time and under exclusive circumstances (such as during dental school or upon first joining the ADA.

The main advantage of guaranteed issue coverage is that there is absolutely no way you can be turned down at the time you sign up. As long as you satisfy all eligibility requirements and pay premiums when due, you are guaranteed to get — and keep — the coverage according to the Plan's provisions. Even if your health deteriorates over time or your financial situation changes dramatically, you can continue to renew the coverage at your option until it expires. And any conversion privileges that exist under the Plan are fully available to you, also regardless of your medical condition.

ADA members may have access to some guaranteed issue coverage through the ADA Insurance Plans:
1. The ADA MedCASH Plan guarantees basic levels of coverage to all members under 60 who enroll. Even your spouse and/or dependent children can get core MedCASH coverage on a guaranteed issue basis as long as you are also a participant in the Plan.
2. Student members (including ASDA members) can get $50,000 in Term Life coverage and up to $2,000 in monthly Student Disability coverage on a guaranteed issue basis, depending on when enrollment takes place.

What does "Own Occupation" mean?

"Own occupation" is the basis used in defining disability coverage under the ADA Income Protection and Office Overhead Expense Plans. Own occupation coverage is the most generous type of disability insurance you can buy. It means that disability is determined by your inability to perform the duties of your specific occupation or profession. (If you are a practicing dentist performing clinical dentistry, then your occupation is the clinical practice of either general dentistry or one of the specialized areas of dental practice approved by the ADA, such as orthodontics or oral surgery.) That's important because your training and education have prepared you specifically for this profession, and if you can't practice dentistry because of a disability, you may be forced to change careers.

By contrast, "any occupation" disability coverage does not consider you disabled if you are still capable of performing the duties of any occupation for which you are reasonably suited, such as teaching, consulting, sales, or administration. If you purchase "any occupation" coverage, you may not receive any cash benefits even though you cannot physically tolerate the rigors of active dental practice.

Own occupation coverage can be difficult to find, and many insurance companies have eliminated or scaled back this type of coverage in recent years. But both ADA-sponsored disability insurance plans, the Income Protection Plan and the Office Overhead Expense Plan, automatically include own occupation coverage for all participants. In fact, under the Income Protection Plan, you can receive full own occupation benefits all the way to age 65, regardless of your age at time of disability, and regardless of any other income you choose to earn while disabled from dentistry. (Other policies may offer own occupation coverage for two or five years at most; after that point, an "any occupation" definition usually determines your eligibility to continue receiving benefits. Still other policies may offset, or reduce, the dollar amount of benefits you receive as a result of income you earn from other sources, like teaching or consulting.) Under the ADA Plan, full own occupation benefits can be payable all the way to age 65 (or for up to two years if you become totally disabled between ages 65 and 69) without any offsets for other income. And rates for ADA disability coverage can be significantly less than other disability insurance, even though the coverage may be much better.

If you're shopping around for the best disability insurance value, consider the impact that an own occupation definition could have on your potential to receive benefits. Dentists are uniquely prone to many types of physical disabilities, and most statistics show you have a 1 in 3 chance of becoming disabled at some point in your professional career. If your family's standard of living relies on your ability to earn income as a dentist, you may decide that it's well worth purchasing the most generous own occupation coverage available.

How long does your "own occupation" coverage last?

In both ADA-sponsored disability plans, your own occupation coverage can be renewed until age 70, providing you with one of the most generous types of disability coverage available. As long as you satisfy all eligibility criteria, the duration of benefits varies by Plan as described below.

Under the ADA Income Protection Plan, full own occupation benefits (with no offsets for income you choose to earn in another occupation while disabled from dentistry) can be paid all the way to age 65, no matter when your disability begins. If you become disabled between ages 63 and 69, you can receive up to two years of own occupation benefits.

Under the ADA Office Overhead Expense Plan, you can receive own occupation benefits up to 12 or 24 times your monthly insured amount (depending on which Benefit Plan you select) for covered expenses incurred within 48 months of the date you first become disabled. If disability occurs from ages 65 to 69, you can receive benefits up to 12 times your monthly insured amount.

How do Premium Credits work?

The Premium Credit is the distribution of Plan surplus that results from favorable recent Plan experience. When a Premium Credit is declared by the ADA, the current Premium Credit is applied in advance to reduce your premium at the time it is due. In fact, all Plan participants benefit from a Premium Credit discount, regardless of age, coverage amount, or length of participation.

A Premium Credit automatically reduces your gross premium and is calculated before any other discount that may apply to your coverage. (Rates quoted include the current Premium Credit if applicable, but do not include other discounts.) While Premium Credits are not guaranteed, these discounts can dramatically reduce your cost of insurance. Returning Plan surpluses to participants is one more way the ADA ensures you get the best insurance value for your dollar.

What is Proof of Insurability?

"Proof of insurability" refers to the written evidence that verifies you are insurable according to the general underwriting standards of the insurance company. Your proof of insurability is generally determined through medical and/or financial underwriting. Please note: Medical underwriting typically involves a paramedical exam (which is arranged at your convenience and at the Plan's expense), blood draw, and a report from your attending physician.

Insurance companies routinely gather information about applicants in order to evaluate each individual who applies for coverage. Every ADA member who requests coverage through the ADA Insurance Plans is individually underwritten. But once you have provided acceptable proof of insurability to initially qualify for coverage, you can continue that coverage as long as each Plan allows, no matter what happens to your medical condition and/or financial circumstances thereafter.

What is the Waiver of Premium option?

The Waiver of Premium feature allows your ADA life insurance coverage to continue, without paying premiums, if you become totally and permanently disabled (unable to perform any occupation) before age 60. Your coverage will continue at full value until it expires, which occurs at age 81 for the Term Life Plan, and age 90 for the Term Plus Plan. And if you have spouse and/or child coverage in force, premiums for that coverage will be waived too.

You can elect this optional coverage for your ADA Term Life and/or Term Plus^® Universal Life coverage. Enhancing your life insurance coverage with the Waiver of Premium option can add tremendous value to your insurance protection.

Is underwriting required to increase my coverage?

In most cases, proof of insurability will be required for any coverage increase. However, you may be able to obtain incremental increases in disability coverage on a guaranteed issue basis under a future increase provision in the contract. This feature is built into the ADA Office Overhead Expense Plan and is available as a coverage option for the ADA Income Protection Plan. Under such provisions, increases can be exercised at a renewal date without underwriting. Certain restrictions may apply, and your billing notice will indicate your eligibility for any guaranteed issue increase.

You can also increase your Hospital Coverage under the ADA MedCASH Plan at any time without medical underwriting, as long as you are under age 60. Upgrades to Critical Condition Coverage, however, are subject to the completion of a brief medical questionnaire.

If I have health problems, can I still get coverage?

Perhaps. Your ability to be approved for coverage will depend on the nature and severity of your medical impairment(s) and the type of coverage you're requesting. Some health problems that may not affect your insurability for one type of coverage could prevent you from acquiring another type of coverage. Regarding disability insurance, you may be offered coverage excluding a certain illness or condition, rather than being declined altogether. Because everyone's circumstances are different, contact a Plan Specialist at 866-607-5338 or ada@gwl.com to discuss your health concerns and personal situation.

How long does it take to be approved?

It typically takes 8 - 12 weeks from the date your application is received until an underwriting decision can be made. However, application processing time can vary depending on the type and amount of coverage requested and the timely availability of your personal information.

You can make a big difference in helping reduce the time it takes to process your application. We appreciate your active involvement and cooperation, and we know you'll appreciate a decision as quickly and efficiently as possible, too. To expedite processing, please follow these pointers:

Make sure your application is thoroughly completed — with all questions answered and all signatures provided — when you first submit it.
Schedule your paramedical exam as soon as possible, then keep your appointment.
Notify your physician's office so they can begin assembling copies of your medical records.
Submit copies of all required federal income tax returns and financial or legal documents along with your application. Financial underwriting requirements and an affidavit of Domestic Partnership (if you are requesting coverage for your Domestic Partner) are available online.

Please note: If you need proof of insurance specifically to provide collateral for a loan, please plan ahead. We will do our best to expedite your application internally, and can even provide your lender with documentation to support the loan approval process.

What is Proof of Insurability?

"Proof of insurability" refers to the written evidence that verifies you are insurable according to the general underwriting standards of the insurance company. Your proof of insurability is generally determined through medical and/or financial underwriting. Please note: Medical underwriting typically involves a paramedical exam (which is arranged at your convenience and at the Plan's expense), blood draw, and a report from your attending physician.

Insurance companies routinely gather information about applicants in order to evaluate each individual who applies for coverage. Every ADA member who requests coverage through the ADA Insurance Plans is individually underwritten. But once you have provided acceptable proof of insurability to initially qualify for coverage, you can continue that coverage as long as each Plan allows, no matter what happens to your medical condition and/or financial circumstances thereafter.

How does HIPAA affect my ADA insurance coverage?

Regulations based on the Health Insurance Portability and Accountability Act of 1996 (HIPAA) apply specifically to the administration of health plans. The MedCASH^SM Plan is the only ADA-sponsored insurance Plan for which HIPAA compliance is relevant. Protected health information (PHI) that you share with Great-West Life when applying for any other insurance coverage is not subject to HIPAA regulation, but we treat all your PHI with confidentiality in accordance with our stated privacy practices.

Basic coverage under the ADA MedCASH Plan is guaranteed regardless of your medical history or condition (and without the exchange of PHI). However, some PHI is required if you apply for optional MedCASH coverage. In that case, Great-West Life will request your authorization prior to reviewing and using your PHI. After receiving your HIPAA authorization, your approval for optional MedCASH coverage will be based on your responses to a brief medical questionnaire.

Do I have to be an ADA member to keep my insurance coverage?

Yes. Because access to discounted group insurance is a major benefit of ADA membership, you are required to be an ADA member in good standing if you wish to continue your ADA-sponsored insurance. Some members say the savings they get on their insurance protection more than makes up for the cost of ADA membership.

How can I change my existing coverage?

You can modify many aspects of your insurance coverage at any time. Many administrative changes require your written authorization; some changes may also require proof of good health. Contact us for assistance, or select an option below. Simply print and complete the appropriate form, and then fax or mail your request to Great-West Life.

Add or change my beneficiary
Change my billing address
Change my insurance ownership
Change my billing frequency
Change my waiting period

If you're interested in more insurance, you can apply to increase your coverage any time before age 60 (or before age 65 for Term Life or Term Plus). Rate quotes are available online, along with downloadable applications for additional insurance. Or you can contact a Plan Specialist at 866-607-5338 or ada@gwl.com for help tailoring your coverage to suit your needs and objectives.

How does HIPAA affect my ADA insurance coverage?

Regulations stemming from the Health Insurance Portability and Accountability Act of 1996 (HIPAA) apply specifically to the administration of health plans. For the ADA-sponsored group insurance policies underwritten and administered by Great-West Life, the MedCASH^SM Plan is the only insurance Plan for which HIPAA compliance is relevant. Protected health information (PHI) that you share with Great-West Life when applying for any other insurance coverage is not subject to HIPAA regulation, but we treat all your PHI with confidentiality in accordance with our stated privacy practices.

The ADA MedCASH Plan is a guaranteed issue policy, which means basic coverage is guaranteed regardless of your medical history or condition (and without the exchange of PHI). However, some PHI is required when you apply for optional MedCASH coverage, and Great-West Life will request your authorization prior to reviewing and using your PHI. After receiving your HIPAA authorization, your approval for optional MedCASH coverage will be based on your responses to a brief medical questionnaire.

What is your privacy policy?

Great-West Life 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. Details about our privacy and confidentiality practices are available online.

Your rights to privacy under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) affect our administration of the ADA MedCASH^SM Plan only. Our HIPAA compliance measures ensure that your personal health information (PHI) is protected at all times. Click here for the Great-West Life Notice of Privacy Practices.

How can I contact Great-West Life?

You can contact us a number of ways:
Applications and sales (toll-free): 866-607-5338
Customer service (toll-free): 800-568-2001
Fax: 303-737-4843
E-mail: ada@gwl.com
U.S. Mail: P.O. Box 340, Denver CO 80201

Every weekday, we are available from 7:00 am to 5:00 pm Mountain Time. Please note: For your protection, certain communications must be made in writing, so please understand if we ask you to submit a written request for something we discuss over the phone.

If our office is closed when you call, you can leave a message to be returned the next business day or at a date and time you specify. E-mail and fax communications are typically returned within the next business day.

ADA Insurance Plans

Frequently Asked Questions

Applying for Insurance

Claims

Coverage Increases

Insurance Products

Premium Payments

Rates

Terms & Definitions

Underwriting

Miscellaneous