Delta Dental Of North Carolina - Employers

Current Location: Delta Dental Of North Carolina > Employers > Q & A

1. How may I reach a Delta Dental of North Carolina sales representative?
2. As a new benefits administrator, what materials and acknowledgment can I expect?
3. What sections on the enrollment form must be filled out?
4. What makes an employee eligible for dental coverage with Delta Dental's smaller employer plans?
5. Does Delta Dental have a minimum premium contribution required by employers to set up a dental plan?
6. How are dental benefits affected if a dependent child is ill or injured and can no longer attend school on a full-time basis?

1. How may I reach a Delta Dental of North Carolina Sales Representative?
Our staff are trained to assist with sales and service of employer groups. Our staff can provide product information, rates, and quotes as well as general assistance for your day-to-day needs. To contact one of our sales representatives, individually rated large groups of 100+ employees call 1-800-587-9514; community rated groups of 5-99 employees call 1-888-332-4617.

2. As a new benefits administrator, what materials and acknowledgment can I expect?
Benefits administrators for our new customers receive a welcome letter, group contract, and administration manual, delivered by his or her broker if applicable. Administrators also receive an identification card and summary plan booklet for each employee. If a broker is associated with the new group, he or she also receives a copy of the welcome letter and contract.

3. What sections on the enrollment form must be filled out?
When submitting enrollment requests it is important to provide complete and accurate information. The benefits administrator and/or broker should insure the employee completes all employee sections of the Membership Enrollment Form and the Membership Maintenance Form. All Requests must also include the Group Representative Name, Telephone Number, Group Name, Group, and Subgroup Numbers on all requests. Send all requests to the attention of the Enrollment Department. If you need assistance in completing a form, contact the Enrollment Department at 1-800-928-6459.

4. What makes an employee eligible for dental coverage with Delta Dental's smaller employer plans?
Full-time employees working a minimum of 20 hours per week or subject to the employer's practice (if greater than 20 hours per week) are eligible. Seasonal or temporary employees are usually not eligible.

5. Does Delta Dental have a minimum premium contribution required by employers to set up a dental plan?
Delta Dental no longer has a minimum premium contribution requirement. If the participation and underwriting requirements are met, the group will be approved for coverage. Group plans that have less than 50 percent employer premium contribution are typically considered to be voluntary.

6. How are dental benefits affected if a dependent child is ill or injured and can no longer attend school on a full-time basis?
Under Michelle's Law, if an unmarried dependent child who was attending a postsecondary educational institution on a full-time basis and is currently covered under the parent's dental benefit policy becomes seriously ill or is injured, he/she may continue to be covered. In order to remain covered, a physician must provide written documentation supporting the need for a medical leave.

Under the law, effective October 1, 2009, students may remain covered under their parent’s dental plan until the earlier of 12 months or until their coverage would otherwise terminate under the policy.

If an unmarried dependent child becomes disabled for an indefinite period of time, (s)he may be considered incapacitated. If the subscriber's dental plan has an incapacitated dependent provision, the subscriber can apply to continue coverage. To be eligible, the dependent:

Must be incapable of self-support because of mental retardation or any mental or physical disability
Became disabled before reaching the age limit for coverage
Depends on the subscriber for financial support and maintenance

In both cases, the subscriber needs to provide document of the illness, injury or incapacitation. The subscriber should print and complete the Disabled DependentMichelle's Law Application. Once the form has been completed by the subscriber and the child’s physician, send it to the employer’s benefit representative who will provide the necessary information to Delta Dental.