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How this plan will work with your Bell Plan:
Plan A
Basic Services
Major Services
Plan B
Basic Services
Major Services
BASIC SERVICES PLAN A
Benefits are the same as your Bell plan.
To illustrate, if your annual dental claim amount is $1,000 (based on current fee guide):
EXAMPLE ONE (If the 1988 rates are 25% of current rates)
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Present Bell Plan
(1988 cost for this work is $250)
90% x $250 = $225
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Green Shield Supplemental Plan
(the actual cost for this work has gone up to $1,000)
50% x $1,000 = $500
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Current re-imbursement from Bell plan only = $225 out of $1,000. (in this example 22.5%)
Re-imbursement using both plans = $725 out of $1,000. (in this example 72.5%) |
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EXAMPLE TWO (If the 1988 rate is 50% of current rates)
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Present Bell Plan
(1988 cost for this work is $500)
90% x $500 = $450
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Green Shield Supplemental Plan
(the actual cost of this work has gone up to $1,000)
50% x $1,000 = $500
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Current re-imbursement from Bell plan only = $450 out of $1,000. (in this example 45%)
Re-imbursement using both plans = $950 out of $1,000. (in this example 95%) |
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EXAMPLE THREE (If the 1988 rates are 75% of current rates)
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Present Bell Plan
(1988 cost for this work is $750)
90% x $750 = $675
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Green Shield Supplemental Plan
(the actual cost of this work has gone up to $1,000)
50% x $1,000 = $500 but because you cannot get more then you actually paid, you would receive $325.
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Current re-imbursement from Bell plan only = $675 out of $1,000. (in this example 67.5%)
Re-imbursement using both plans = $1,000 out of $1,000. (in this example 100%) |
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E.&O.E.
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MAJOR SERVICES PLAN A
Benefits are the same as your Bell plan.
To illustrate, if your annual dental claim amount is $3,335 (based on current fee guide):
EXAMPLE ONE (If the 1988 rate is 25% of current rates)
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Present Bell Plan
(1988 cost for this work is $834)
60% x $834 = $500
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Green Shield Supplemental Plan
(the actual cost for this work has gone up to $3,335)
30% x $3,335 = $1,000(max. allowed)
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Current re-imbursement from Bell plan only = $500 out of $3,335. (in this example 15%)
Re-imbursement using both plans = $1,500 out of $3,335. (in this example 45%) |
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EXAMPLE TWO (If the 1988 rate is 50% of current rates)
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Present Bell Plan
(1988 cost for this work is $1,667)
60% x 1,667 = $1,000
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Green Shield Supplemental Plan
(the actual cost for this work has gone up to $3,335)
30% x $3,335 = $1,000(max. allowed)
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Current re-imbursement from Bell plan only = $1,000 out of $3,335. (in this example 30%)
Re-imbursement using both plans = $2,000 out of $3,335. (in this example 60%) |
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EXAMPLE THREE (If the 1988 rate is 75% of current rates)
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Present Bell Plan
(1988 cost for this work is $2,501)
60% x $2,501 = $1,000 (max. allowed)
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Green Shield Supplemental Plan
(the actual cost for this work has gone up to $3,335)
30% x $3,335 = $1,000(max. allowed)
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Current re-imbursement from Bell plan only = $1,000 out of $3,335. (in this example 30%)
Re-imbursement using both plans = $2,000 out of $3,335. (in this example 60%) |
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NOTE: The maximum re-imbursement allowed under MAJOR services is $1,000 per plan. Therefore the maximum you can collect each year using both plans under major services is $2,000 per person per year. A $25.00 per person/$50.00 per family annual deductible per plan also applies to major services. Please remember, however, that BASIC services has no annual maximum and no deductible.
E.&O.E.
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BASIC SERVICES PLAN B
Benefits are the same as your Bell plan.
To illustrate, if your annual dental claim amount is $1,000 (based on current fee guide):
EXAMPLE ONE (If the 2 year old rate is 75% of current rates)
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Present Bell Plan
(2 year old cost for this work is $750)
80% x $750 = $600
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Green Shield Supplemental Plan
(the actual cost for this work has gone up to $1,000)
20% x $1,000 = $200
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Current re-imbursement from Bell plan only = $600 out of $1,000. (in this example 60%)
Re-imbursement using both plans = $800 out of $1,000. (in this example 80%) |
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EXAMPLE TWO (If the 2 year old rate is 85% of current rates)
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Present Bell Plan
(2 year old cost for this work is $850)
80% x $850 = $680
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Green Shield Supplemental Plan
(the actual cost of this work has gone up to $1,000)
20% x $1,000 = $200
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Current re-imbursement from Bell plan only = $680 out of $1,000. (in this example 68%)
Re-imbursement using both plans = $880 out of $1,000. (in this example 88%) |
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EXAMPLE THREE (If the 2 year old rate is 95% of current rates)
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Present Bell Plan
(2 year old cost for this work is $950)
80% x $950 = $760
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Green Shield Supplemental Plan
(the actual cost of this work has gone up to $1,000)
20% x $1,000 = $200
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Current re-imbursement from Bell plan only = $760 out of $1,000. (in this example 76%)
Re-imbursement using both plans = $960 out of $1,000. (in this example 96%) |
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E.&O.E.
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MAJOR SERVICES PLAN B
Benefits are the same as your Bell plan.
To illustrate, if your annual dental claim amount is $1,500 (based on current fee guide):
EXAMPLE ONE (If the 2 year old rate is 70% of current rates)
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Present Bell Plan
(2 year old cost for this work is $1050)
50% x $1050 = $525
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Green Shield Supplemental Plan
(the actual cost for this work has gone up to $1,500)
20% x $1,500 = $300
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Current re-imbursement from Bell plan only = $525 out of $1,500. (in this example 35%)
Re-imbursement using both plans = $825 out of $1,500. (in this example 55%) |
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EXAMPLE TWO (If the 2 year old rate is 80% of current rates)
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Present Bell Plan
(2 year old cost for this work is $1,200)
50% x 1,200 = $600
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Green Shield Supplemental Plan
(the actual cost for this work has gone up to $1,500)
20% x $1,500 = $300
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Current re-imbursement from Bell plan only = $600 out of $1,500. (in this example 40%)
Re-imbursement using both plans = $900 out of $1,500. (in this example 60%) |
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EXAMPLE THREE (If the 2 year old rate is 90% of current rates)
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Present Bell Plan
(2 year old cost for this work is $1,350)
50% x $1,350 = $675
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Green Shield Supplemental Plan
(the actual cost for this work has gone up to $1,500)
20% x $1,500 = $300
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Current re-imbursement from Bell plan only = $675 out of $1,500. (in this example 45%)
Re-imbursement using both plans = $975 out of $1,500. (in this example 65%) |
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NOTE: The maximum re-imbursement allowed under MAJOR services is $1,500 per plan. Therefore the maximum you can collect each year using both plans under major services is $3,000 per person per program year (July to July). Please remember, however, that BASIC services has no annual maximum and no deductible.
E.&O.E.
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