Dental Benefits

2021 Benefits 

Savers Administrative Services, an Asure Software Company, will continue to administer to dental reimbursement plan.

Dental Premiums

  • Employee Only - $4.62 per pay period
  • Employee and Family - $18.46 per pay period

Dental Benefits Summary

Amount of ServiceCity ShareEmployee ShareCity Paid Benefit
First $300100%0%$300
Next $500%$50 deductible$0
Next $25080%20%$200
Next $1,60050%50%$800


  • Orthodontia is only available to covered dependents under the age of 19
  • Orthodontia has a lifetime maximum benefit of $1,500


  • A Dental Claim Form, a Reimbursement Estimate Form, and other helpful information can be downloaded from the Savers Admin website.
  • The Reimbursement Estimate Form can be submitted to Savers Admin by the employee or the dental provider to help determine – prior to having a procedure – how much the Dental Reimbursement Plan will pay.
  • The Dental Reimbursement Plan is funded by Employer dollars, so dental claims must be submitted to the Dental Reimbursement Plan before any FSA funds are used.
  • For employees enrolled in the Dental Reimbursement Plan and the FSA, their FSA card will not be accepted for dental expenses beginning January 1, 2018.
  • On the dental claim form, FSA participants may, however, request for Savers Admin to pay any unreimbursed eligible dental expenses from their FSA funds. (Must have current FSA enrollment and available funds.)
  • Claim default is to reimburse the employee, but a Pay Provider option is available on the Dental Claim Form.
  • Either the employee or dental provider may submit a Pay Provider claim. Proceeds paid directly to the dental provider.
  • Pay Provider claims must be manually submitted; online submission for Provider Pay is not supported.
  • Dental claims are processed daily. Claims received by 11 a.m. on a business day are processed the same day.
  • Direct Deposit for employee reimbursement is encouraged. Faster and more secure than mailed checks.
  • Obtain Dental Claim Forms, Reimbursement Estimate Form, Dental Reimbursement Plan Benefit Summary, and other helpful information on the Savers Admin website.
  • View claims history and account balances at the Participant Portal.

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