State Specific Rules

California

Help for members impacted by wildfires in southern California

Renaissance Life & Health Insurance Company of America (“RLHICA”) is making temporary changes with respect to the dental and vision plans we offer, to provide relief and ensure healthcare access for our members who live in Los Angeles and Ventura counties in California and have been impacted by the recent wildfire emergency.

The changes listed below have been in effect since January 7, 2025, and will continue until we receive further guidance and notice from the California Department of Insurance.  RLHICA has not experienced, nor does it expect to experience any disruptions to its operations, as all critical operations are based outside the impacted counties in California.

• Description of RLHICA’s plan for communicating with affected members

Covered members with questions about care and coverage will be able to access RLHICA’s customer service department representatives during normal business hours or access our website for information on coverage/benefits, participating providers, status of a claim or to obtain new ID cards.  In addition, any covered members who have opted into receiving electronic communications will receive this same information from RLHICA via an email and/or text message.    

• Relaxing time limits for prior authorization, precertification, or referrals.

RLHICA does not require prior authorization, precertification or referrals in connection with its covered services.

• Extending filing deadlines for claims.

RLHICA’s dental and vision policies already provide that members may submit claims for up to one (1) year after services are rendered (potentially longer in cases of incapacity).

• Authorizing a member to replace necessary equipment, prosthetics or supplies.

Covered members may use their coverage to replace medically necessary equipment, prosthetics or supplies during the State of Emergency, subject to their regular cost sharing requirements. Covered members shall be responsible for paying no more than their ordinary in-network cost sharing. 

RLHICA shall waive all utilization management restrictions and limitations on the number or frequency of replacements for medically necessary equipment, prosthetics and supplies that were left behind, lost, damaged or destroyed. 

• Allowing members to access an appropriate out-of-network provider if an in-network provider is unavailable.

If covered members are unable to access their regular dental or vision provider due to the declared state of emergency, they may contact our customer service department or visit our website to access a listing of other in-network providers to meet their health needs. In the event there are no other in-network providers available to meet a members’ health needs, any out-of-network provider services will be covered on the same basis as services provided by an in-network provider.  Members need not first contact RLHICA when accessing an appropriate out-of-network provider or facility in the foregoing instances.  

• Providing a toll-free telephone number that an affected member may call for answers to questions, including questions about the loss of health insurance identification cards, access to prescription refills, or how to access health care.

Covered individuals may contact our customer service department at (888) 791-5995 or visit our website to address their health care related questions or to obtain new insurance identification cards. Members who are part of their employer sponsored group plan can contact us by calling 800-894-4532.

• Billing leniency for members for nonpayment of premium.

RLHICA acknowledges and will comply with the request of Commissioner Lara to provide a 30-day insurance premium grace period for all California policies covering member residents in Los Angeles and Ventura counties.   

These changes are for impacted members who have RLHICA dental and/or vision coverage through group health plans offered by their employers, or our individual plans.  RLHICA is committed to its members’ health and welfare and will continue to monitor and make further adjustments to its practices as necessary, to help members living in Los Angeles and Ventura counties access dental and vision care during this ongoing State of Emergency.

Colorado

Colorado Statement

A copy of the Renaissance Network Access Plan for our benefit plans utilizing the Renaissance network of dentists is available here or will be provided in writing, upon request.

A copy of the Renaissance Network Access Plan for our benefit plans utilizing the Delta Dental PPO™ or Delta Dental Premier® network of dentists is available here or will be provided in writing, upon request.

Connecticut

Connecticut Statement

Renaissance is committed to offering a robust provider network that maximizes the number of dentists and vision doctors available to ensure all covered services will be accessible without unreasonable delay to its subscribers and their eligible dependents. The Renaissance Dental Network consists of the following three, nationwide leased network partners: the Maverest Dental Network (www.myzelis.com/maverest), Careington Maximum Care Network (www1.careington.com) which also includes the DenteMax Network, and the Connection Dental Network (www.ppousa.com/Connection-Dental-Network). For both its group and individual vision plans, Renaissance utilizes the national Choice Vision network owned and maintained by Vision Service Plan (“VSP”). Renaissance uses software to run provider accessibility and availability mapping within a geographic region. This permits a determination of the number of providers by area of practice and geographic segment (city, county, etc.) and a corresponding visual representation of this distribution, which identifies where further targeted provider recruitment may be necessary. In addition, Renaissance entertains input from subscribers, groups, and carriers who request that certain providers be added to the network or requires a targeted recruitment.

Renaissance’s networks are required to certify their sufficiency, including time and distance standards and provider-to-enrollee ratios, by comparing the Renaissance covered membership for all areas to the participating provider’s location and specialty.

Providers participating in the Renaissance networks are credentialed and re-credentialed according to stringent guidelines, which require a thorough check of malpractice history, verification of licensure, verification of adequate malpractice coverage, verification of education, regular monitoring against government sanction lists and other quality checks upon initial credentialing and re-credentialing.

If your provider is no longer participating in our Renaissance network, members will receive written notification via letter directing them to our website to use the “Find a Doctor” search function. For assistance, members can call customer service for group plans at 888-358-9484 or for individual plans 888-791-5995.”

Idaho

Renaissance does not offer ACA plans in Idaho.

The plans referred to on this website include:

Group Dental: D-ID-1202A v4
Group Disability: ICC17-LTDI-200A-2017
Group Life: ICC17-GTL-200A-2017
Group Vision: V-200A-2015-ID
Individual Dental: INVD-100A-2016-ID
Individual Vision: VINV-100A-2016-ID

Maryland

The Maryland Insurance Administration issued Bulletin 24-9 in response to the collapse of the Francis Scott Key Bridge.

Renaissance will make reasonable accommodations to prevent loss of insurance coverage due to non-payment of premiums. Accommodation includes:
• suspension of premiums that are due;
• extension of billing due dates and premium grace periods; and
• waiver of installment and late payment fees.

Should you have any questions, please Contact Us.

West Virginia

Review a copy of the Renaissance Network Access Plan, or one can be provided in writing upon request.

Virginia

MCHIP Statement

In accordance with 12 VAC 5-408-230 (L), Virginia MCHIP covered persons, providers, and employers may request a copy of Renaissance Life & Health Insurance Company of America’s annual performance results by contacting:

Renaissance Life & Health Insurance Company of America

Customer Service Department

PO Box 1596

Indianapolis, IN 46206-1596

Virginia Covered Persons

Renaissance is accepting requests from Virginia covered members to actively serve as participants on its quality assurance committee. If you are interested in becoming a member of the Renaissance quality assurance committee, please email compliance@renaissancefamily.com with your interest and contact information. Renaissance will reach out to you with any additional requirements.