What is the difference between an in-network and out-of-network provider?
A Dental PPO (Preferred Provider Organization) plan offers a network feature. PPO and Premier dentists participate in the network thereby agreeing to accept contracted fees as payment in full rather than their usual fee for patients. When you visit a PPO or Premier dentist, you typically pay a certain percentage of the reduced rate (called coinsurance) and the plan pays the rest. Preventive and diagnostic services are covered at 100%. However, if you visit a dentist outside of the network, you may incur higher out-of-pocket costs. Watch the video below for further details on Delta Dental's networks.
What is an annual maximum?
An annual maximum is the maximum dollar amount a dental benefit plan will pay toward the cost of dental care within a specific benefit period, usually a calendar year. You can determine how much you've already used by checking your benefits and eligibility on the Member Connection.
What is coinsurance?
The portion of the cost of your dental treatment that you are required to pay. Most dental plans pay a pre-determined percentage of the cost, and you pay your coinsurance amount even after your deductible is reached.
What is a deductible?
A specific dollar amount that you must pay before the dental plan begins to cover your expenses.
What is an explanation of benefits or EOB?
This is a document you receive from Delta Dental after you visit the dentist. It is not a bill, but rather an explanation of what procedures were performed and what was covered by your dental plan. Though EOBs vary across Delta Dental member companies, they should include the dentist's fee, the portion Delta Dental paid and any amount you may owe (such as deductible, coinsurance or non-covered services). It should also include an update on how much of your annual maximum has been used and the amount you've paid toward your deductible.
What is considered a Qualifying Life Event?
A qualifying life event includes a change in marital status (marriage or divorce), a birth of a child, adoption of a child, or loss of other coverage. If you have had a qualifying life event, please contact the Benefit Partners Group student support team at (877) 247-8817. You can enroll under a qualifying life event up to 60 days after such event. If you miss that window, you will have to wait for the next available open enrollment period.
How do I access the Delta Dental member connection?
The dental insurance policies are written for a period of 12 months from your effective date. You may elect to continute coverage or discontinue coverage only after your coverage duration has ended.
Can I cancel my insurance plan?
Once premium has been paid and your policy is in-force, there will be no cancellations, refunds, or early termination of coverage. There is a $25 fee for any issues related to payment via check or credit card processing.
Who is Benefit Partners Group?
Benefit Partners Group administers the enrollment and payment process for the student dental plan. If you have any questions, please contact the Benefit Partners Group student support team toll-free at (877) 247-8817.
Who do I contact with questions about enrollment, benefits or claims?
If you have enrollment, payment, or billing questions, please contact Benefit Partners Group toll-free at (877) 247-8817. If you are already enrolled, and have questions about claims or other benefit related information, you should contact Delta Dental customer service at (800) 544-0718, or email them at email@example.com.