FAQs - Enrollment Guidelines
Making Changes to Your Enrollment
You may add, reinstate, terminate, or make status changes for employees or dependents at any time during the year. All other enrollment changes must be made during your group's open enrollment period.
Please submit all eligibility additions and changes directly to the Enrollment Department via the Online Enrollment section of the web site. Eligibility changes submitted on your invoice will not be processed. Please complete an Enrollment Form and submit additions and changes to:
Delta Dental of Massachusetts
Attn: Enrollment Department
465 Medford Street
Boston, MA 02129 |
Non-routine urgent requests may be faxed to (617) 886-1293. To ensure that eligibility information is entered into our system accurately, please review each enrollment form for completeness and clarity.
Adding Members
You may add the following members at any time during the year:
- a new employee (the effective date must be based on either the date of hire or the end of the employee's initial probationary period).
- an employee who has experienced a qualifying event that results in the loss of coverage from another plan sponsor.
- dependents as the result of a marriage, birth, adoption, or a qualifying event that results in the loss of coverage from another plan sponsor.
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Reinstating Subscribers
Subscribers who have chosen to cancel their dental coverage may re-enroll during your company's open enrollment period, and their dental benefits will be reinstated on your group's anniversary date. Subscribers must wait at least one year from the date of voluntary cancellation before re-enrolling in the dental plan. For example, if a subscriber cancels their dental coverage in March, and your group's anniversary date is July, the subscriber must wait the one full year until the following July anniversary date to re-enroll.
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Terminating Members
You can terminate a member's dental coverage at any time. For DeltaCare and DeltaCare USA plans, please notify us within 25 calendar days of the termination date. For all other dental plans, please notify us within 72 days of the termination date. If a subscriber's claim is paid after the termination date, but before we receive notice of the termination, we will use the date the last claim was paid as the termination date for billing purposes.
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Making Status Changes
In some cases, subscribers may experience a change of status and elect to switch their benefits from individual to family coverage or from family to individual coverage.
Switching from an individual to a family membership: Subscribers may switch from an individual to a family membership anytime there is an event that marks a status change, such as a marriage or the birth of a child. For DeltaCare and DeltaCare USA plans, please inform us within 25 calendar days of the effective date of the change in coverage. For all other dental plans, please inform us within 72 calendar days of the effective date of the change in coverage. All other changes from individual to family members will go into effect on your group's anniversary date.
Switching from a family membership to an individual membership: Subscribers may switch from a family to an individual membership at any time. For DeltaCare and DeltaCare USA plans, please inform us within 25 calendar days of the effective date of the change in coverage. For all other dental plans, please inform us within 72 calendar days of the effective date of the change in coverage. If we have paid any claims for the member after the effective date, but before we receive notice of the status change, we will use the date the claim was paid as the effective date. Unless the subscriber marries or has a child, he or she must wait at least one year after the effective date to change back to family status.
For all status changes, we will honor the effective date of the qualifying event.
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Notification Requirements
When you add, reinstate, terminate, or make status changes for employees or dependents on your DeltaCare or DeltaCare USA plan, you will need to notify us within 25 calendar days of the change. For employees or dependents on all other dental plans, you will need to notify us within 72 calendar days of the change. When necessary, we will issue new ID cards and mail them to the subscriber's home within 10 days of receipt of the information.
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