Delta Dental of Michigan

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Frequently Asked Questions About Selling Delta Dental Programs


What’s the minimum group size required for a quote?

The minimum group size for our plans is 10 employees. However, we also offer standardized plan options for small businesses with 2–9 eligible/enrolled employees. Rates for these group segments are pooled for best overall savings.
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What’s the minimum contribution level from the employer?

The minimum contribution level from the employer is 50 percent of the employee rate, unless you are selling a voluntary program.
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What’s the minimum participation requirement?

Delta Dental requires a minimum participation of 75 percent of the eligible employees (35 percent with voluntary plans) with a minimum of 10 employees.
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How many employees are required to quote orthodontics?

We require a minimum of 25 employees before we will quote orthodontics, unless the group had orthodontic coverage through their previous carrier.
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Are there any waiting periods for services?

No. Delta Dental does not have waiting periods for services, except for our voluntary plans.
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What’s the waiting period for new hires?

The waiting period for new hires is usually a minimum of 30 days after the date of hire. A few industries require a mandatory 90-day new hire waiting period, such as doctors, lawyers, architects, auto dealerships, and country clubs. Our voluntary plans also include waiting periods.
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Does Delta Dental have a pre-existing condition clause?

No. Delta Dental’s programs have no exclusions or limitations for pre-existing conditions.
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Explain Delta Dental’s position on Certificates of Portability.

Dental is excluded unless the medical and dental are tied together. Since Delta Dental underwrites plans on a stand-alone basis, the aspects of HIPAA concerning certifications of creditable coverage do not apply. (Also, Certificates of Portability were created to address pre-existing condition clauses. Delta Dental does not underwrite plans with pre-existing condition clauses.)
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Do enrollees experience balance billing with Delta Dental?

No. Delta Dental enrollees are responsible only for their copayments, deductibles, and charges for noncovered services, if any, when they visit a participating Delta Dental dentist. Our participating dentists agree to accept our fee determination as full payment for covered services.
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What materials will the enrollees receive after the program is implemented?

Our standard materials include a program certificate booklet along with a summary of dental plan benefits describing the coverage levels. Additionally, the group will receive an administrative manual, eligibility enrollment forms, a dentist directory (if applicable), and a re-order form for materials.
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What are the commissions paid by Delta Dental?

Delta Dental offers a flat percentage based on group size. Please see our contract or Agent Commission Schedule. Outside of this schedule, commissions can be determined on a group-specific basis, subject to rating adjustment.
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Explain the methods of reporting eligibility.

Methods of reporting eligibility include online, tape, enrollment forms, diskettes, and forms used by some other carriers.
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