Employer Dental Plan FAQs

When can employees make changes to their dental plan?

Changes can be made during the group’s open enrollment period or at the time of a qualifying event.

What are some qualifying events?

Marriage
Divorce
Death
Birth of a child
Loss of other health insurance coverage

How long can employees be on COBRA?

An employee’s period of coverage depends on their qualifying event and their eligibility.

What is rollover maximum?

A financial savings tool that encourages members to maintain strong preventive habits in order to accrue more benefit dollars. Please refer to your benefit materials or contact your sales representative for more information.

What happens if an employee is covered by more than one dental plan?

Delta Dental will coordinate coverage with the other carrier(s) to enable them to receive the maximum allowable benefit from each plan. This process, known as Coordination of Benefits (COB), allows reimbursement up to the total cost of the dental services. Employees should include all COB information on their enrollment forms.

If an employee has two separate dental plans, which one is primary?

The primary carrier is the one that covers the employee as the enrollee (e.g., through their employer rather than their spouse’s employer). If they have two jobs, the plan that has covered them longer is primary.

Which is the primary dental plan for children with parents living together or married?

The primary carrier is determined by the “birthday rule.” Coverage of the parent whose birthday (month and day, not year) comes first in the year is the children’s primary coverage. For example, if the mother’s birthday is in April and the father’s birthday is in September, the mother’s plan is primary. If both parents have the same birthday, the plan that has covered either parent longer is primary.

Which is the primary dental plan for children whose parents are divorced, separated or not living together?

The plan that covers the parent with whom the child lives provides primary coverage. (In joint custody cases, the plan that has covered either parent/stepparent longer is primary).

When a child is covered through remarriage or domestic partnership, coverage is determined in this order:

Primary: plan that covers the parent the child lives with
Second: plan that covers the custodial parent’s spouse or domestic partner
Third: plan that covers the other parent
Fourth: plan that covers the other parent’s spouse or domestic partner

If the above rules do not determine which plan is primary, coverage will be shared equally between plans. Finally, these rules are superseded by a court order establishing the person responsible for the child’s coverage.

How can I get a replacement card for an employee?

Call 800-872-0500 or login to your online account.