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Maximum Bonus Account

Enrolled members who practice good oral health habits - including visiting the dentist for regular check-ups - often don't use much of their available benefits. Wouldn't it be nice if you could save those unused benefits for the future?

Our Maximum Benefit Account (MBA) feature, included in select plans, makes that possible. The MBA feature rewards those with good oral health with additional benefits to use later if more expensive services are needed in the future. There are limitations, so read further to understand how this plan feature works.

Eligibility & benefit

If an enrolled member has:

  1. Been covered by the plan for at least 1 full benefit year;
  2. Completed all benefit waiting periods included in their plan;
  3. Submitted at least one claim for a covered service (non-orthodontic) during the benefit year; and
  4. Used less than half of the plan's annual maximum benefit that plan year, 

Then $250 of the unused benefits will be placed in a Maximum Benefit Account for the enrolled member to use in a future year.  The MBA account can grow up to an amount equal to the annual maximum benefit of the plan.

Example

John's dental plan has a $1,000 annual maximum benefit. John's two regular check-up claims totaled $300 for the plan year, and no other claim was filed. With the MBA feature, $250 will be added to his benefits the following year, effectively giving him a $1,250 maximum benefit for the year.

If John's second year of claims includes two claims for regular checkups and a cavity filling that total $480 for the plan year, his MBA account will grow by another $250 to a total of $500, effectively giving him a $1,500 maximum benefit for the year.

Orthodontic maximums not included

The MBA does not apply to orthodontic benefits, which are still limited to the plan's Lifetime Orthodontic Maximum benefit.