Dental, Vision, & Insurance Benefits FEDERAL & POSTAL EMPLOYEES+
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Insured Free Choice 50+ States Page 2
50 State Insured Dental & Eye Care
Application & Payroll Deduction Forms
Direct Deposit from your Checking Account or Pay Check-you may pay Premium & Enrollment Fees DHMO
California Dental HMO Plans with VisionCare
Texas Dental HMOs With Vision Benefits
Dental HMO Plans in states other then CA or TX OK to enroll from DC-PR-VI & APO Addresses
Vision Benefits That Are with the Dental HMO Plans Vision with the PPO is an Insured Plan
Dental & PPO or go to any dentists in California Blue Cross
Disability - Life - Cancer Insurance Plans
Brochures you may VIEW or DOWNLOAD
This is the home page.                 Payroll Deduction Benefits
Insurance Coverage with your Choice of Dental & Vision Office
Tax Free Benefits No one will be refused coverage .... open to all 
     WE ARE NOT CLOSING OUR ENROLLMENT___
 
Licensed in all 50 States DC+ use PPO for added benefits. 
In select areas DHMOs with Vision.  Payroll deduction, direct bill, credit card
 
Providers Include:  Comp Benefits; Ameritas Group; American National, Blue Cross & others
 
Open Enrollment to all: Federal & Postal Employees, Retired, TEs, Reserves Active & Not, National Guards, part-time, seasonal, management, union members-staff, plus their families. USO, Volunters, any government affiliation.  Surviving Spouse, children, over-age children, parents, grand children, siblings, domestic partners treated same as spouse for premiums with Ameritas Group & First Ameritas Life Insurance Co of NY .
 
APWU Memebers serving locals of APWU, NALC, NAPUS, NTEU, ICE, NARFE, and other locals

click here to view Free Choice of Providers Dental & Vision "Fusion Brochure" with PPO

Link click here for Dental Providers with the Fusion Plan and Select > NATIONWIDE PPO NETWORK you only need to put in your zip code

click here for Fusion eye care providers in your area: Eye Med Lenscrafters, Pearle-Cole Vision, TSO, Eye Masters major chains, private offices and more including some Sears & Targets are included,not yet on the LINK over 40,135+ contact points you only need to type in your zip code, unless you need directions from your home.

click here to view our vision advantages insurance, discounts, & maximums providers may charge.

click here to view vision chain providers

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We offer two (2) types of Dental & Vision Plans.  Each type has three (3) Options.

 

1.  Insured, Free Choice of Providers “Fusion”

Insured plan everywhere with free choice of dental and vision offices.

This plan is also has a PPO, which the Ameritas Group calls “Fusion”, as dental & vision are” fused” together for extra benefits.  The PPO contracts with dental & vision offices for a maximum fee that they may charge you per procedure. 

 

This Fusion Plan gives the maximum flexibility of choices with no pre-selection of providers for any family member.  The increasing benefit with  Dental RewardsSM and the availability of receiving a pre-treatment review to make sure you are charged correctly is reassuring.  Additional detail is available in the insurance certificate.

With this plan, it is also easier to nominate a dentist to participate.

  Children are covered up to age 24

and domestic partners and their children may be added the same as a spouse and children.  No increase in premium or decrease in benefits when you leave government service or retire.

 

This is NOT a self insured trust. Being an insurance policy, you may go to your state’s insurance department for assistance.  The Ameritas Group claim service is one of the best, as, rated by Standard & Poors for claim quality. We are so confident in our claim service that if you wish to terminate, you may do so at any time. Although we would like you to stay enrolled for a year,  re-enrolling is possible with limitations described as a late entrant.

 

2.  Dental HMOs with Vision.

These plans give you the lowest out of pocket at the dental office fees and the lowest premiums.

The limitations here are that dental HMO providers are not as numerous as those on the PPO.

Your  family  will all go to the same dental office, unless you pay a single premium for a family member to go to a different dental office, which may also be in a different state.  Various levels of benefits are available.

Orthodontics is covered without a waiting period and includes adults & children, however, a limited number of offices are available.   The orthodontic panel, is also available to PPO subscribers. 

The vision benefit is a discount referral service with savings to 60%, no pre-selection of provider, and over 12,000 offices.

 

Which plan is the best for you?   This only you can decide.

Hopefully the above information helps to make this choice easier for you. 

 PPO gives the most freedom on provider selection and superior vision coverage reimbursement & discounts.

 

 DHMO give the lowest out of pocket at the dentist with lowest premiums

Both types are available to enroll in at the same time        

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Email Questions & to Nominate Provider for DHMOs PPO nomination of providers the link is @ the Nationwide Network Link

APWU Members, I.C.E., NALC, NTEU with qualifying locals pay no enrollment fee.
 
Compare:  Dental RewardsSM and benefits to $2,000 Maximum
    Dental HMOs where available...No Maximum
 
Your Choice of Provider for children's Orthodontics
 only 12 month waiting period compare with others!
 
DHMO no waiting period for Orthodontics
     Coverage for Adults & Children
DHMOs     Children covered to age 23 except Texas
    DHMOs Texas Comp Benefits covered to age 25
    see how to add over-age kids, grand kids, parents
 
Fusion Free Provider Choice Dental & Vision with
           PPO > Children covered to age 24 (not 22)
           This is an insurance plan fully licensed.
 
Claim service high rating by Standard & Poors.
 99.3% accuracy
 
3+ Million Enrolled PPO No Deductble Type 1
$ 50 Type 2 &3 $ 25 Vision  The Fusion of Dental & Vision
 
Free Choice with PPO option Same Premium
        All 50 States & DC 3 benefit levels
 
Fully Insured-Not a Self Insured Trust,
Administrator with over 35 years in the Federal Market 
 
See specifics for adding Over Age Children, Parents
   Grand Children, Siblings with either you or them
   paying the premium
 
PPO With Over 34,000 Employer Groups

Eye Care Reimbursement Going To "Your Choice" Eye Care Office

    Sample $45 Exam $120 Contacts specific amounts for lenses and frames

Subscriber using contracted Eye Med offices have a maximum fee that may be charged.

** Single Vision Lenses $50, Bifocal $70, Trifocal $105 any frame 35% off retail                             SEE PAGE 2 for details.

 

You may go to Dr. Expensive, Costco, or anywhere!

Insured Free Choice with PPO BROCHURE

          Nominate Providers Bottom of this page.
Insured Dental and Eye Care "Fusion Plan The Ultimate Choice"  with
Free Choice of dental and vision providers or contracted offices for additional advantages.  Fully Insured all 50 States + DC  & PAYROLL DEDUCTION
 
Survivor Benefit is included for both spouse and children.
   With the same coverage as active employees.... we take care of clients.
 
World Wide Coverage... No one refused.
UNIFI total assets in excess of $25 Billion
 
An insurance plan is not a "junk referral discount plan" with or self insured trust with questionable benefits.  With Fusion by Ameritas Group you will receive a certificate of insurance with your identification card by a company LICENSED AS AN INSURANCE COMPANY IN ALL 50 STATES & DC.
 
Dental RewardsSM 
 

Gives you up to an increasing maximum by $350 per year per Family Member in 3 years by $1,000 to

a $2,000 Maximum Benefit per year per family member

 
Network:
Over 77,500 dental points of access.
Over 40,135 eye care providers and retail locations as of 1/18/2006
 
Including Lens Crafters, Pearle & Cole Vision, some Sears & some Target locations (which are not yet included on the "Link Below")

Dental Rewards Click here for More Information

Even if The Federal Employee Health Benefits Program you are enrolled has Dental &/or Vision... usually so minor it seems they don't exist you may have "Real Benefits" from an insurance company licensed in all 50 states & DC THAT PAYS $$$

click here to view Fusion Brochure Free Choice DDS & Eye Vision Provider

Link to Vision Plan that is with all Dental HMO Plans by clicking You will now "Jump" to that page

Federal & Postal Employees Families & Retired may input their application online and download their payroll deduction form & application.
 
Direct Bill Annual, Semi-Annually, or Quarterly is
also available and Automatic Deduction from your
personal bank account available now Check-O-Matic.
You may now pay your premium and or enrollment fee BY CREDIT CARD on this web=site or from your personal checking account through Automatic Bank Draft>Check-O-Matic. We will take the money out of your bank account. 
You may also pay by Credit Card or Check-O-Matic for your Annual, Semi-Annual, or Quarterly Premium. 
 
Fusion Dental & Eye Care is only available by Payroll Deduction, Check-O-Matic or Credit Card Monthly or Quarterly, you may be billed by Email if you wish and make payment by bank draft or quarterly, and the only "paper" Direct Bill is Quarterly.
 
The enrollment membership fee for WITH THE Dental HMO Plan  is a first year only fee of $20 you may pay it by Credit Card or by Check-O-Matic or check.  The membership fee with the DENTAL & Eye Care Fusion Insured Plan is $20 for self or self  & family
 
Credit Card (VISA or MC) DHMO payments.
No additional charge to pay $20 Enrollment Fee by automatic bank draft add $3 for Enrollment Fee only paying by credit card.
 

DHMO Payments Visa or Master Card 

Credit Card fees added to all DMO premiums are $4 under $100
$8 for $100-$199 and shall increase by $4 etc.
 
Fusion by Ameritas Group, see brochure for all premiums.
Federal or Postal Employee MAY Enroll ONLINE & Submit your premium and/or one time only enrollment fee online. 
American Marketing Administrators, Inc.
Insurance Agency & Registered Insurance Administrator Since 1980
23901 Calabasas Road Suite 2014
Calabasas, CA 91302-3307
818-223-9750, Fax 818-223-8147, alternate fax 818-992-4438 800-300-PLAN

application, 1199 payroll deduction form, credit card, or bank draft use

click here to download bank draft & DHMO Premiums

Email Questions> we will do comparisons with other plans and how our Plans would work for you!

Online Application click to submit below when finished.
 
The Fusion Ameritas PPO Plan is separate and not related or affiliated in anyway whatsoever to the Dental HMO plans that are provided by different companies.  These plans are provided to give you more options by your group.
 
Please, answer all questions, if you have a question on premium amount or anything please email us below.
 
If you wish to make a payment and you are already enrolled you may provide your information here and indicate it is only a payment at the last question
 
The Fusion Dental & Vision Plan includes the PPO option.
If you wish to have this plan and a Dental HMO then you would select "both" in the online application below.

Name: Last, First, Mi as it appears on your pay check or retirement check
Social Security # for claiming of premiums only not used as an ID
Employer -Agency & Location if Retired from where?
Dental Plan Selected: example: 550V, 13V, ANTX, 110V, HO, or Free Choice Fusion with PPO. You may have BOTH DHMO & Fusion with PPO; Type E1, E2, or E3
Home Street
Home City
Home State
Home Zip + 4 if you know it
Home Area Code
Home Phone
Home Fax
Primary Email Address:even though you are submitting on line we will not have your email address if you do not add it here
Work Street
Work City
Work State
Work Zip + 4 if you know it
Work Phone Area Code
Work Phone
Work Fax
Work Email
Date of Birth (example 07/11/1979)
Spouse Name
Spouse Date of Birth (09/25/1980)
Name Child(ren) & Date of Birth
Premium Mode - How you wish to pay?: Payroll Deduction, A, SA, Q, CHECK-O-MATIC, or CCPayroll deduction
Check-O-Matic-Bank Draft
Annual >DHMOs only
Semi-Annual >DHMOs only
Quarterly
Credit Card [MC-VISA only]
Premium Amount (we will inform you of needed corrections) if unsure please ask prior to input to Payroll. Let us help you.
Have you started or will you start shortly your payroll deduction with your employer through Employee Express or NFC National Finance Center or PostalEASE?? & any questions? Yes or No?
Yes, Insured Free ChoiceFusion Plan by Ameritas Group with PPO optionYes, I want Insured Fusion Denta & Vision Plan with Free Choice of providers & PPO option
No, I do not want Fusion Plan with Free Provider Choice & PPO included
I WANT BOTH Fusion PPO & Dental HMO & will be paying a premium for each
I want dental HMO with Vision & not Ameritas PPO
Which Fusion with Free Provider Choice & PPO Plan do you select? Please, select the Insured Free Choice Plan You Want?Plan E1 High Level Benefits
Plan E2 Mid Level Benefits
Plan E3 Standard Benefits
NO Fusion Free Choice with PPO
I only want the DENTAL HMO with Vision
Yes or No for Dental HMO _Panel OnlyYes, I want the Dental HMO with Vision
No, I do not want Dental HMO with Vision
I Want BOTH DHMO & Fusion Free Choice with PPO & I will be paying 2 premiums
I want one of the PPO Plans E1.E2.or E3
DENTAL HMO select the plans dental office by typing in the DDS Code# no pre-provider selection required for the Fusion Plan with PPO
After reading and understanding this section PLEASE CLICK THE BOX TO THE RIGHT. In several states, we are required to advise you of the following: Any person who knowingly and with intent to defraud provides false, incomplete or misleading information in an application for insurance or who knowingly presents a false or fraudulent claim for payment of a loss or benefit, is guilty of a crime and may be subject to fines and criminal penalties, including imprisonment. In addition, insurance benefits may be denied if false information provided by an applicant is materially related to a claim. If a required premium increase occurs and the client does not change the payroll deduction (if payroll deduction is selected), which he/she understands would be necessary and required then the amount the administrator may change the client/subscribers plan to a different plan coverage, and company. As an employee/member, I hereby apply for insurance or health benefits, for which I am eligible or may become eligible. This information was explained in the plan solicitation materials, and enrollment is for a minimum of twelve months, which I have read and understand. PLEASE CLICK BOX TO THE RIGHTYes I accept and understand
Please Confirm TYPE IN THE:> Premium, Plan & Mode of Payment (example: Payroll, Bank Draft, Credit Card, Direct Bill Q, SA, or Annual, Plan ie E1,E2,E3,-HO-550V-110-ANTX etc.
Use Bank Draft Check-O-Matic. (Lower cost then quarterly direct bill or credit card).Click to RIGHT so we know what you Want
Expedite Enrollment with payment by Bank Draft Input Routing # & Bank Account # also download check-o-matic form and mail or fax with voided check
To Expediate Enrollment by Credit Card or other Options Click to right PLEASE SEE OTHER OPTIONS
Credit Card Payment by MC or VIsa input your credit card type; number, expiration date, & last 3 digit security code from the back of your card.
Name as it appears on Credit Card
Credit Card Billing Address
Confirm 3 digit (end of #s) Credit Card Security Code from back of credit card
I understand I will be mailing a copy of the payroll deduction form with the enrollment fee if applicable CLICK IF YESYes I will be sending in a copy of the 1199 after I go to PostalEASE, NFC, or Employee Express
I will be mailing the Premium and Enrollment Fee for the Direct Premium for Fusion only Quarterly is available DHMOs SA & Annual are availabale
I will be mailing the Enrollment Fee
I wish the enrollment fee paid by check-O-Matic
I wish the enrollment fee paid by credit card and understand there is an additional handling fee
I will not be making any payment by Bank Draft
Enrollment Fee Paid By What Method?
NAME of Agency-Employer?
For Postal Employees Only. Are you an APWU Member?I am an APWU Member
I am not an APWU Member
If an APWU member my APWU Local is? & Phone#
How many brochures may we send for the people you work with?
> IF YOU WISH TO ADD non immediate family members to your plan you may. They will PAY THE PREMIUM of a Single Adult (couple or family) additional to your BASIC PREMIUM. We need their Name, Date of Birth, Social Security #, # of additional people and their relationship: (example: Over Age Child(ren), Grand Child(ren), Parent(s), Domestic Partner, Sibling(s), those that need coverag. You may have them pay the premium because of you or add to your premium.
I have a Questions?
Are you interested in receiving information on additional insurance-do not worry we will not be sending an agent.yes
no
Disability Insuranceyes
no
Cancer additional lump sum benefityes
no
Life Insurance with 3 questions? 1. Are you working today? 2. Do you have Aids? 3. Missed work in last 3 months?Yes, send me info on life insurance
No Thank You we have plenty of Life Insurance
Comments
If making a payment on an existing account include the Plan#
  

To see the submit button to click go all the way to the right and click once  >
 
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No need to pre-select Eye Care offices for the Eye Care benefits with either the Dental HMOs (discount from Coast to Coast) or the Fusion 50 State +DC Plan with "free choice" of Eye Care office and receive insurance reimbursement or use contracted offices for added advantages.
 
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Eligibility is the First of the Month after the second payroll deduction (or first of the month after Expediting Enrollment by Credit Card, Bank Draft, or Quarterly and the premium and all requirements are received by the administrator AMA
 
Postal Employees are required to return a signed copy, in two places, of the alloment form and authorization, and writing "copy" on it even though they have started payroll deduction by "PostalEASE."
 
 

click here to view or download PostalEASE information

Thank you for enrolling.  If you did not provide a primary email address above, even though you enrolled online we did not receive information on your email address this was setup this way for your privacy.

 

You will now need to download the 1199 Payroll Deduction Form and mail it with the $20 Enrollment Fee for all Fusion PPO Plans with Free Choice of Dental or Eye Care Provider, regardless of family size to American Marketing Administrators. (AMA).

 

To pay the enrollment fee you may fax or mail a copy of the 1199 Payroll Deduction form and use Check-O-Matic or provide credit card information, an additional shipping and handling fee applies to credit card use, to (AMA).

 

The enrollment fee for the Dental HMO Plans is $20.  Check payable to American National Dental or use credit or debit card.

 

Credit Card number, expiration date, name on the card, 3 digit security code from the back of the card, and the billing address for the credit card if it is different.  You may email this to:

        payments@federaldentalportal.com

 

If you wish to pay by direct (such as) quarterly you will also need to include the premium for the direct bill.

 

If you wish to expedite enrollment by either a bank draft use the Check-O-Matic form or provide credit card information (MC & VISA only), mail or                                                                                                               

 

 fax (818-223-8147  alternate fax 818-992-4438)

Nominate a Provider Click Here for the PPO Fusion Plan; Claim Forms; Enroll Dependent Under Disabled Status.

American Marketing Administrators, Inc.
Ameritas Group Federal & Postal Employees Dental & Vision Plans
Insurance Agency & Registered Insurance Administrator Since 1980
23901 Calabasas Road Suite 2014
Calabasas, CA 91302-3307     Email: info@fdvp.com
818-223-9750, Fax 818-223-8147, 800-300-PLAN
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