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Main -> Dental Plan -> Co-ordination of Benefits?
Coordination of Benefits?
Coordination of Benefits means that if you and your spouse are both recipients under a dental plan, you may claim up to 100% of the cost of an insured service from the two plans combined.
* To file a claim for Coordination of Benefits (COB):

If you are a teacher making a claim for dental work on yourself, first file a claim with the Teachers' Dental Plan. Any amounts not reimbursed may be submitted for payment by your spouse's plan. Attach a copy of the Statement of Benefits that you received from the Teachers' Dental Plan to the applicable dental form.

- Spouses of eligible teachers claiming for dental work on themselves, would submit first to their applicable employers' dental plan (if they have one) and any unpaid amounts may be submitted to the Teachers' Dental Plan. When x-rays have been submitted with a claim to the spouses dental plan, the Teachers' Dental Plan also requires the x-rays to be submitted with the COB claim.
- If the claim is for dental work on a dependant child, first determine which parent has the earliest birth date (month and day) in the year. The claim should be submitted to the plan pertaining to the parent with the earliest birth date. Once payment has been received, file a dental claim form against the second plan attaching a copy of the Statement of Benefits received with the initial claim.
- If you are a teacher married to a teacher, and you are both eligible under the Teachers' Dental Plan, you may also claim for COB. If you are making a claim for dental work on yourself, file a claim against your own coverage under the Teachers' Dental Plan. At the time you file your claim, attach a COB claim completed by the spouse, and once your claim is processed any residual amounts will be claimed against your spouse's coverage. If you are making a claim for dependant children, determine whether the first claim should be against your coverage (i.e. first birth date as described above) or your spouse's coverage. If you attach a claim for COB completed by the spouse, once the first claim is processed any residual amounts will be claimed against the spouse's coverage.
* Dentists will be required to complete two applicable dental plan forms.
  Who Will Pay?
  What Are the Costs?
  When Am I Eligible?
  Are Dependants Covered?
  Coverage and Level of Benefits?
  What About Fee Changes?
  Plan Limitations
  Prior Estimates?
  How Do I Claim?
  Co-ordination of Benefits?
  Benefits After Termination?
  Additional Information?
  Maximum Reimbursement Levels (.pdf)
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