The NLTA Group Insurance program provides reimbursement of many eligible Dental Services. The insurer reimbursement is based on reasonable and customary charges at the 2020 Newfoundland and Labrador Dental Association General Practitioner and Specialist Fee Guide.
Starting in January 2021, in situations where Dental Offices charge more than the 2020 Newfoundland and Labrador Dental Association suggested fees for services (e.g. 2021 suggested fees) the teacher portion of the cost will increase as the NLTA Dental program will only pay 80% of the 2020 suggested fee.
Situations may arise where alternate methods of treatment may be available. The insurer reserves the right to reimburse only the least expensive procedure that will provide a professionally adequate result. It is recommended that insured members obtain a pre-determination treatment plan of significant Dental expenses. The treatment plan is not intended to limit the member in their choice of a Dentist or what procedures should be performed. The intent is to avoid any misunderstanding as to the extent of the Dental Coverage provided. The treatment plan should be sent to the plan administrator Johnson Inc who will provide a pre-determination of eligible expenses covered under the Dental program and the amount payable by the member in excess of the program’s coverage.