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Frequently Asked Questions to Brokers from Groups
How do I confirm that a group's employee is eligible for coverage?
How do employees verify their children’s full-time student status?
What happens if an employee’s child reaches the maximum dependent age and is no longer a full-time student?

An employee misplaced his/her ID card. How can he/she get a replacement?

An employee has a fully disabled dependent. How long can the dependent’s dental benefits coverage continue?
When should groups expect their billing statement to arrive? 
When are groups' Delta Dental premiums due each month?

How far back can a group's account be credited for changes/terminations?
Can an employee add a family member to his/her dental coverage at any time?
What does Delta Dental consider a qualifying event?
What if an employee wants to elect coverage during a contract year?
When does coverage begin after a qualifying event occurs?
How can a group administrator get a dental benefits summary for an employee?
Can a group change its new hire waiting period?

 

Q: How do I confirm that a group's employee is eligible for coverage?
A:
To check an employee’s eligibility status, you may contact our office at 307-632-3313 or 1-800-735-3379.

Q: How do employees verify their children’s full-time student status?
A: Please provide Delta Dental with a copy of a document that proves the student is enrolled at a secondary institution and is taking at least 12 credit hours. Acceptable documentation includes a copy of a paid tuition bill or a letter from the registrar.

Q: What happens if an employee’s child reaches the maximum dependent age and is no longer a full-time student?
A: Dental coverage terminates at the end of the month in which the child reaches the maximum dependent age or is no longer a full-time student. However, the child may be eligible for COBRA benefits if the employer is required to offer COBRA.

Q: An employee misplaced his/her ID card. How can he/she get a replacement?
A: Please contact our office at 301-632-3313 or at 1-800-735-3379 and we will send them replacement cards.

Q: An employee has a fully disabled dependent. How long can the dependent’s dental benefits coverage continue?
A: As long as the individual remains disabled and is fully dependent on the member for support and unmarried, he or she can remain a dependent on the member’s dental policy. Written proof is required from the attending physician to verify the dependent's disability.

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Q: When should groups expect their billing statement to arrive?
A: Delta Dental generates billing statements on the 15th of each month for the following month.

Q: When are groups' Delta Dental premiums due each month?
A: Payment should be submitted to Delta Dental by the due date printed on the invoice (billing statement).

Q: How far back can a group's account be credited for changes/terminations?
A:
Credits for changes and terminations on your group’s account are generally limited to 90 days prior to the current billing cycle in accordance with the Delta Dental contract.

Q: Can an employee add a family member to his/her dental coverage at any time?
A: No. Dependent family members can only be added at the renewal date of the group contract if the employer allows open enrollment periods or when a qualifying event occurs.

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Q: What does Delta Dental consider a qualifying event?
A: The following are considered qualifying events:

  • Birth/legal custody/adoption
  • Death
  • Loss of other dental insurance coverage
  • Marriage/divorce

Q: What if an employee wants to elect coverage during a contract year?
A: Coverage begins the first of the month following the date the qualifying event occurs.

Q: When does coverage begin after a qualifying event occurs?
A: Coverage begins the first of the month following the date the qualifying event occurs. Delta Dental must receive notice of the change in eligibility status within 31 days of the qualifying event. Otherwise, the change may only be made at the renewal date of the group contract if the employer allows such open enrollment.

Q: How can a group administrator get a dental benefits summary for an employee?
A: You can contact our office at 307-632-3313 or 1-800-735-3379, or visit the Employers section of the website. Also, a Benefits Booklet explaining coverage is mailed to each newly enrolled employee within 10-14 business days unless the employer elected to provide the Benefits Booklet in another manner.

Q: Can a group change its new hire waiting period?
A: The contract signed by the group defines the waiting period. The waiting period applies to all new employees. Some contracts may allow changes to the waiting period. Please contact your Delta Dental Account Executive to inquire about contract revisions.

 


If you have additional questions, please contact us .