LEASED NETWORK DISCLOSURE
Per the terms of your Participating Provider Agreement, on or after July 1, 2011, Dental Benefit Providers, Inc.
(hereinafter “DBP”) shall lease its network of PPO dental providers to the Lincoln National Life Insurance
Company (hereinafter “Lincoln”). Lincoln shall market and sell dental PPO products to consumers in your
geographic location and such consumers shall utilize DBP’s PPO provider network.
The following provides details of the arrangement between DBP and Lincoln, and your obligations to Lincoln and
its members:
1. From time to time, DBP may lease or rent its provider network to a third party such as Lincoln. Accordingly,
DBP shall notify you of all such partnerships in the future.
2. It is expected that you shall provide dental services to Lincoln members in the same fashion and to the same
standards as you provide dental services to DBP / UnitedHealthcare Dental members.
3. The terms of your Participating Provider Agreement with DBP remains effective and controlling.
4. Lincoln actively encourages its members to utilize the DBP network by providing its members in-network
discounts on covered services and provides its members access to a listing of the DBP network, which includes each
provider’s name and location. DBP requires that all leased network partners actively encourage its membership to
utilize the DBP network.
5. The fees currently applicable to our National PPO plans are also applicable to Lincoln approved PPO products in
your geographical area. You shall be compensated for services provided to Lincoln PPO members based on the
same fee schedule in place for our National PPO plan.
6. All claims for services provided to Lincoln members shall be delivered to the following:
For questions regarding the administration, status or payment
Submit claims to:
of a claim:
Lincoln Financial Group
Lincoln Financial Group
Dental Claims Input Center
Attn: Claim Service Team
P.O. Box 614008
8801 Indian Hills Drive
Orlando, FL 32861
Omaha, NE 68114
Electronic Payer ID Number:
Email: [email protected]
CX061
Phone: 1-800-423-2765
7. All payments, explanation of benefits, and claims denials shall clearly indicate Lincoln as the responsible party
for payment.
8. All inquiries, concerns, complaints, and grievances shall continue to be handled by DBP.
9. All Lincoln member identification cards shall identify the DBP network.
10. You may access a listing of all DBP leased network partners online at www.dbp.com, or you may request a
listing at 1-800-822-5353.
ID Card Sample:
Front:
Employer:
Group Policy #:
Employee Name:
Dependent Coverage:
The Lincoln National Life Insurance Company
Back:
Dental Claims Input Center
P.O. Box 614008, Orlando, FL 32861
Electronic Payer ID Number: CX061
Fax to (877) 843-3945
To verify benefits, call (800) 423-2765
To check claim status, email: [email protected]
Call our toll-free number and receive a fax showing the patient’s eligibility & benefits in less than 5
minutes.
Predetermination of Benefits: For treatment plans costing at least $300, we recommend that your
dentist submit the proposed treatment and the proposed fees to the address or fax shown above.
We will send an estimate of payment to you and your dentist.
Visit www.jpfic.com to: Order/Print Dental ID card; View/Print your Dental Benefits; Access
Lincoln DentalConnectSM health center for locating a dentist, dental health information and a
dental cost estimator tool.
Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.
Possession of this card is not a guarantee of coverage or benefits.
GLC-06995
2/11
LEASED NETWORK DISCLOSURE
Per the terms of your Participating Provider Agreement, on or after January 1, 2013, Dental Benefit Providers, Inc.
(hereinafter “DBP”) shall lease its network of PPO dental providers to the Solstice Benefits, Inc. (hereinafter
“Solstice”). Solstice shall market and sell dental PPO products to consumers in your geographic location and such
consumers shall utilize DBP’s PPO provider network.
The following provides details of the arrangement between DBP and Solstice, and your obligations to Solstice and
its members:
1. From time to time, DBP may lease or rent its provider network to a third party such as Solstice. Accordingly,
DBP shall notify you of all such partnerships in the future.
2. It is expected that you shall provide dental services to Solstice members in the same fashion and to the same
standards as you provide dental services to DBP / UnitedHealthcare Dental members.
3. The terms of your Participating Provider Agreement with DBP remains effective and controlling.
4. Solstice actively encourages its members to utilize the DBP network by providing its members in-network
discounts on covered services and provides its members access to a listing of the DBP network, which includes each
provider’s name and location. DBP requires that all leased network partners actively encourage its membership to
utilize the DBP network.
5. The fees currently applicable to our National PPO plans are also applicable to Solstice approved PPO products in
your geographical area. You shall be compensated for services provided to Solstice PPO members based on the
same fee schedule in place for our National PPO plan.
6. All claims for services provided to Solstice members shall be delivered to the following:
Submit claims to:
For questions regarding the administration, status, eligibility
Solstice Benefits
or payment of a claim:
Solstice Benefits
P.O. Box 14009
P.O. Box 19199
Lexington, KY 40512- 4009
Plantation, FL 33318
Electronic Payer ID Number:
Email: [email protected]
76578
Phone: 1-877.760.2247
Fax: 954.370.1701
7. All payments, explanation of benefits, and claims denials shall clearly indicate Solstice as the responsible party
for payment.
8. All inquiries, concerns, complaints, and grievances shall continue to be handled by DBP.
9. All Solstice member identification cards shall identify the DBP network.
10. You may access a listing of all DBP leased network partners online at www.dbp.com, or you may request a
listing at 1-800-822-5353.
ID Card Sample:
Front:
Back: