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(IBEW Local 11 and LA NECA only) - Benefit Tabs™
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New Participant Portal
You can enroll for the new Participant Portal experience. Click here for instructions on how to access the new Participant Portal.
Register for New Participant PortalActive Health Plan Benefit Tabs™
This is a summary of benefits and not a substitute for the Southern California IBEW-NECA Health Plan Summary Plan Description, and to the extent it differs from the SPD, the terms of the SPD will govern.
- Eligibility
- Choice of Plans
- Blue Shield
- Kaiser
- UnitedHealthcare
- Dental
- Vision
- Life Insurance
- Cont. Coverage
- Member Assistance Program (MAP)
- Health Reimbursement Arrangement
Dental Plans
United Concordia PPO | DeltaCare USA DHMO | United Concordia DHMO
United Concordia Dental Plan (DHMO)
How the Plan Works
United Concordia provides a list of DHMO dentists to you when you enroll. You must sign up with one of these dentists and receive all dental services from that provider or dental practice. You can change dentists by phoning United Concordia at the number shown below. Only procedures listed on the schedule of benefits are covered.
Sample Procedures
| Code | Procedure | Your Copay |
Plan Pays |
|---|---|---|---|
| 00120 | Periodic Oral Exam | $0.00 |
100% |
| 01120 | Prophylaxis - Child | $0.00 |
100% |
| 02150 | 2 Surface Amalgam | $0.00 |
100% |
| 02792 | Full Gold Crown | $0.00 |
100% |
| 03330 | Molar Root Canal | $0.00 |
100% |
Schedule of Procedures
Annual Maximum
There is no annual maximum benefit.
Orthodontics
Covered for adults & children according to fee schedule.
Additional Information
Customer Service Phone Number: 866-357-3304
Web Site/Provider Lookup: www.ucci.com
Plan Number: Plan 701
My Dental Benefits Account
United Concordia Dental mobile app
How to Access Your Digital Member ID
Cómo acceder a su Tarjeta de identificación de miembro digital
Evidence of Coverage