Member Terms, Conditions and Disclosure Agreement

Updated 11/17/2025

The Gentle Dental Smile Plan (the "Plan") is administered by Gentle Dental Smile Plan, LLC ("GDSP").

GENTLE DENTAL SMILE PLAN TERMS & CONDITIONS:

THIS IS NOT INSURANCE. This is a reduced fee dental plan. By paying an annual membership fee you (and if applicable, your eligible family members) will be entitled to receive dental services at reduced rates. By joining, you indicate that you have read and agree to the terms and conditions of the Plan and affirmatively consent to its provisions.

CHOICE OF DENTISTS

To be entitled to the reduced rates you and your eligible family members must visit a participating provider. A participating provider list can be found online at gentledental.interdent.com/smile-plan or by calling (800)-755-8622.

WHEN MEMBERSHIP BEGINS

Plan membership begins on the calendar day your application is received.

MEMBERSHIP FEES

You are responsible for paying an annual membership fee to participate in this Plan.

Applicable membership fees for the initial year of services are as follows:

PLAN ELIGIBILITY

Single individuals, domestic partners, married couples and their dependents are eligible. Dependents are eligible between 4-26 years of age (regardless of whether the dependent is attending school, living outside the parent’s home, or married.) Membership may be continued for a dependent over the age of 26, if the dependent is incapable of self-sustaining employment by reason of developmental or physical handicap.

DISCOUNT FEES

A Plan fee schedule can be obtained online at gentledentalsmileplan.com, through a participating provider, or by calling member services at (800)-755-8622. Fees are discounted as listed in the current fee schedule. Fees not listed in the fee schedule will be discounted 20%. Specialty fees will be discounted by 25%. Specialty services are available at any participating specialty dental provider.

The Plan reserves the right to update the Plan fee schedule at any time. Savings are based upon the provider’s normal fees. Actual savings will vary depending upon location and specific services or products purchased. Please verify such services with each individual provider. All listed or quoted prices are current prices by participating providers and subject to change without notice. Updated fees at the time of service will apply to all dental services received by you and your family members.

All provider fees are due at time or service or according to terms between member and provider. No portion of any provider fees will be reimbursed or otherwise paid by the Plan.

AUTOMATIC RENEWAL NOTICE

This agreement includes an automatic renewal feature. Unless you opt-out or cancel, your subscription or service will automatically renew at the end of each term for the same duration and at the then-current rate. At the end of your membership term, you authorize the Plan and provide your affirmative consent to charge your credit card or checking account for the plan you have selected, and your credit card or checking account will be automatically charged for the appropriate amount, unless or until you notify us that you wish to cancel the Plan.

CANCELLATION POLICY

You may cancel your subscription or automatic renewal at any time before the renewal date. To cancel, you may use one of the following methods:

• Email: Contact us at GDSmilePlan@gentle1.com
• Mail or Fax: Send a written cancellation notice to:
  

  Gentle Dental Smile Plan, LLC
  2260 E. Imperial Hwy., 8th Floor El
  Segundo, CA 90245
  Fax: (866) 647-0699

• Call: Call us at (800)-755-8622

If you cancel your membership within 30 days of enrollment, you shall receive a full refund of membership fees, if services have not been performed by a provider. If services have been performed, the member must pay the difference between the providers UCR and the plan discount fee.

TERMINATION CONDITIONS

We reserve the right to terminate plan members from the Plan for any reason, including non-payment. If the Plan or your membership in the Plan is terminated for a reason other than non-payment, you shall receive a pro-rata refund of your membership fees.

PRICE AND TERM CHANGES

We may update the renewal price or term by providing notice prior to renewal. Continued use of the service after the renewal date constitutes acceptance of the new terms.

CONFIDENTIALITY OF MEDICAL RECORDS:

We are committed to maintaining the confidentiality and security of all members’ medical information and comply with all HIPAA laws and regulations. We will not disclose members’ medical information without the member’s authorization, unless required or permitted by law. Any disclosure of medical information beyond the provisions of the law is prohibited.

GRIEVANCE PROCESS

Our commitment to you is to ensure not only quality of care, but also quality in the treatment process. This quality of treatment extends from the professional services provided by Plan providers to the courtesy extended to you by our representatives.

If you have questions about the services you receive from a Plan provider, we recommend that you first discuss the matter with your provider. If you continue to have a concern regarding any service you received, please contact us.

Gentle Dental Smile Plan, LLC
2260 E. Imperial Hwy., 8th Floor El
Segundo, CA 90245
Phone: (800)-755-8622
Fax: (866) 647-0699
gentledental.interdent.com/smile-plan

DUAL COVERAGE

The Plan is available to patients without a primary dental policy. The Plan is not a supplementary plan and cannot be used in conjunction with insurance plans or other discount plans or programs.

SPECIALTY SERVICES

Specialty services are covered under the Plan; however not all participating providers provide specialty services. You will receive the discounted fees for specialist services under this Plan only if those services are received from a participating provider. If your participating provider does not provide specialist services, please call us at (800) 755-8622 to see if there is a nearby participating provider who can perform specialty services.

THESE TERMS & CONDITIONS ARE BINDING FOR ALL APPLICATION SUBMISSIONS ON PAPER OR ELECTRONIC VIA OUR ONLINE WEBSITE. BY JOINING THE PLAN, YOU AGREE TO BE BOUND BY ALL THE TERMS AND CONDITIONS IN THIS DESCRIPTION.

If you have any questions regarding this Plan or the terms and conditions, please call (800)-755-8622 or write:

Gentle Dental Smile Plan, LLC
2260 E. Imperial Hwy., 8th Floor El
Segundo, CA 90245
Fax: (866) 647-0699
gentledental.interdent.com/smile-plan