|
| GROUP NUMBER |
GROUP NAME AND PAYMENT PROCESS DETAILS |
| 6318 & 4357 |
Boston Teacher's Union
Paid off a specific table-$2,000 lifetime orthodontic maximum paid in two payments, six months apart. Do not usually meet their maximum-$57 for each month of treatment plus $381 for records and banding.
Please note: Non-par is paid at a reduced fee. $45.60 for each month. $304.80 for records and banding. |
| 6563 |
Interstate Electrical
$1,500 lifetime orthodontic maximum-paid out in one payment. |
| 7525 |
The New England Carpenters (formerly Massachusetts State Carpenters)
$2,000 lifetime orthodontic maximum-paid out in one payment. |
| 7850 |
The TJX Companies
$1,000 lifetime orthodontic maximum with a $500 calendar year maximum. Receive one lump payment of $500 for the first year. Must resubmit the second year for the remaining $500 paid out in monthly installments. |
| 4309 |
NSTAR
Only Sublocations 7430-7432 & 9997 that have a $1501 lifetime maximum that is paid out as follows: Four payments that are each six months apart. First payment is $760, six months later a payment of $285, six months later $228, and the final payment six months later of $228.
Please note: There are some NSTAR sub-locations that have an $1800 maximum. These are paid monthly but must be submitted each month. |
| 3615 |
Tweeter Home Entertainment
$1500 lifetime orthodontic maximum with a $750.00 calendar year maximum. Receive $750 for the first year in monthly installments. Must resubmit the second year for the remaining $750 paid out in monthly installments. |
| 2397 |
Massachusetts Bricklayers
$2600 orthodontic lifetime maximum with a cap of $1300 paid per fiscal year. The fiscal year runs from July 1st through June 30th. Two orthodontic payments are made 6 months apart as long as the second payment is in a different fiscal year. If the second payment would fall in the same fiscal year, wait until the following July to submit for the second payment. |
| 7007 |
Massachusetts Public Employees
Quarterly payments are based on length of treatment. Please submit a copy of the pre-estimate with date of service at the specified payment intervals to receive payment of orthodontic benefits. |
| DeltaCare |
All groups that have the DeltaCare product
Please submit a claim with the initial date of banding or date appliance is placed. Six months later please submit claim with date of service for remaining orthodontic benefits. |