A Dental Plan Organization (DPO) is any person or company who
provides directly or arranges to administer one or more plans providing dental
services that are on a prepaid or postpaid individual or group capitation
basis. The covered person is eligible to receive treatment from in-network
dentists only (except in the case of an eme
rgency over fifty (50) miles from
home). The covered person may be required to pay a deductible or copayment
for treatment, but no balance billing is allowed.
The enabling legislation, N.J.S.A. 17:48D-1 et seq., was effective
06/01/1980. The corresponding regulation, N.J.A.C. 11:10-1 et. seq., was effective
07/15/1985. As a result of regulatory amendments effective August 21, 2000,
DPOs are allowed to use specialty pools to pay providers for certain specialized
dental services.
Participating specialty dentists are paid on a fee-for-service
basis from the pool.
|
| Aetna Dental, Inc. |
Aetna US HealthCare Customer Service
151 Farmington Ave.,
Hartford, CT 06156 |
| Telephone: 1-800-843-3661 |
| NAIC Number: 11183 |
| NJ
Date of Admission: 03/03/91 |
|
| ALPHA Dental Programs Inc. |
| 12898 Towne Center Drive,
Cerritos, CA 90703 |
| Telephone: 1-800-422-4234 |
| NAIC Number: 95163 |
| NJ Date of Admission: 12/19/06 |
|
| Atlantic Southern Dental Foundation/BeneCare |
| 615 Chestnut Street,
Suite 1001,
Philadelphia, PA 19106 |
| Telephone: 215-440-1000 |
| NAIC Number: 11217 |
| NJ Date of Admission: 03/21/84 |
|
| CIGNA Dental Health of NJ, Inc. |
| 300 NW 82nd Ave.,
Suite 700,
Plantation, FL 33324 |
| Telephone: 1-800-367-1037 |
| Web site: |
| NAIC Number: 11167 |
| NJ Date of Admission: 10/31/85 |
|
| Dental Delivery Systems, Inc. |
| 2826 Mt Carmel Ave.,
Glenside, PA 19038 |
| Telephone: 215-224-8888 |
| NAIC Number: 11195 |
| NJ Date of Admission: 06/27/86 |
|
| Dental Services Organization, Inc. |
| 1030 St. Georges Ave.,
Avenel, NJ 07001 |
| Telephone: 732-634-4810 |
| NAIC Number: 11234 |
| NJ Date of Admission: 07/27/85 |
|
| Flagship Health Systems, Inc. (d/b/a Flagship Dental Plans) |
| 1639 Route 10, PO Box 222,
Parsippany, NJ 07054 |
| Telephone: 973-285-4000 |
| Web site: |
| NAIC Number: 11179 |
| NJ Date of Admission: 06/06/86 |
|
| Group Dental Health Administrators, Inc. |
| 236 East Westfield Ave.,
Roselle Park, NJ 07204 |
| Telephone: 908-241-9700 |
| NAIC Number: 11246 |
| NJ Date of Admission: 01/28/86 |
|
| Horizon Healthcare Dental, Inc. |
| 3 Penn Plaza East, PP03-Q,
Newark, NJ 07105-2200 |
| Telephone: 973-466-7304 |
| NAIC Number: 11146 |
| NJ Date of Admission: 07/12/94 |
|
| International Healthcare Services, Inc. |
| 333 Earle Ovington Blvd., Suite 300,
Uniondale, NY 11553 |
| Telephone: 1-800-468-0600 |
| NAIC Number: 11173 |
| NJ Date of Admission: 09/14/84 |
|
| LIBERTY Dental Plan Organization of New Jersey, Inc. |
| 1730 Flight Way, Suite 125, Tustin, CA 92782 |
| Telephone: 949-271-3945 |
Toll Free: 1-888-273-2997 |
FAX: 949-270-0102 |
| E-mail: MajaK@LibertyDentalPlan.com |
| NAIC Number: 11159 |
| NJ Date of Admission: 04/28/03 |
|
| John D. Kernan, DMD, PA |
| 644 Westmont Plaza,
Cuthbert and MacArthur Blvd.,
Westmont, NJ 08108 |
| Telephone: 856-869-8660 |
| NAIC Number: 11182 |
| NJ Date of Admission: 09/29/85 |
|
| Managed DentalGuard, Inc. |
| 4 Campus Drive,
Parsipanny, NJ 07054 |
| Telephone: 973-396-4700 |
| NAIC Number: 11199 |
| NJ Date of Admission: 11/29/01 |
|
| MetLife Health Plans, Inc. |
| 501 Route 22,
Bridgewater, NJ 08807 |
| Telephone: 949-425-4172 |
FAX: 949-425-4587 |
|
| NAIC Number: 14170 |
| NJ Date of Admission: 12/19/11 |
|
| Union Security DentalCare of New Jersey Inc. (Formerly Fortis) |
| 2323 Grand Blvd.,
Kansas City, MO 64108-2670 |
| Telephone: 1-800-443-2995 |
| NAIC Number: 11244 |
| NJ Date of Admission: 09/15/84 |
|
| United Concordia Dental Plans, Inc. |
| 1800 Center Street, Suite 2B 220, Camp Hill, PA 17011 |
| Telephone: 1-800-972-4191 |
| Web site: |
| NAIC Number: 95253 |
| NJ Date of Admission: 09/16/94 |
|
|
|
A Dental Service Corporation (DSC) is a corporation which is
organized without capital stock, and not for profit, for the purpose of establishing,
maintaining and operating a nonprofit dental service plan. The expense of
dental services by dentists, who are reimbursed on a fee for service basis,
to covered persons, is paid in whole or in part by the DSC in return for premiums
paid by or on behalf of those covered persons.
The covered person may be required
to pay a deductible and/or copayment depending on the plan. If the plan provides
benefits for services provided by dentists not participating in the plan,
the covered person may also be responsible for charges which are over and
above the maximum set by the plan (balance billing).
Dental Service Corporations
are regulated by N.J.S.A. 17:48C-1 et seq. effective 09/26/1968.
There are
two active Dental Service Corporations operating in the State of
New Jersey, as follows:
|
| Delta Dental Plan of NJ, Inc. |
| 1639 Route 10,
Parsippany, NJ 07054 |
| Telephone: 973-285-4000 |
| NAIC Number: 55085 |
| NJ Date of Admission: 5/13/70 |
|
| Dental Practice Association of New Jersey, Inc. |
| One Independence Mall,
615 Chestnut St., Suite 1001, Philadelphia, PA 19106-4404 |
| Telephone: 215-440-1000 |
|
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