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REMINDERS Timely Access to Care - premierlife.com

Timely Access to Care One of your rights is to timely dental care. This means that you have the right to certain appointment wait times. An appointment wait time is the time from the initial request to the earliest date offered. Non-Urgent Appointment (Initial/Routine) – within 36 business days

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EMPLOYEE ENROLLMENT/CHANGE FORM

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*All references to “Premier” herein refer to Premier Access Insurance Company Other Dental Coverage Do you or your dependents have other dental coverage? Yes No (If yes, completethe informationbelow.)

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Table 1: Federally Required Adult Dental Services (FRADS)

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Table 1: Federally Required Adult Dental Services (FRADS) - Continued CDT-4 Code D7140 root (elevation and/or forceps removal) D7210 D7220

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