Employers

Frequently Asked Questions


Web Registration:

Q. Can I manage my group's Delta Dental plan online?
Q. How do I register?
Q. What type of browser do I need to view my account?
Q. How can I get a lost password reset?


Benefits:

Q. What does my group's plan cover?
Q. Who should I contact to change my group’s covered benefits?
Q. Does the Affordable Care Act (ACA) affect my group’s dental benefits?
Q. What are Essential Health Benefits?
Q. What does the Pediatric Essential Dental benefit cover?
Q. Who is eligible for Medically Necessary Orthodontia under the ACA?


Eligibility:

Q. When can I enroll a new employee?
Q. How do I change an employee’s coverage status from individual to family?
Q. Who is covered on a family plan?
Q. Are dependents covered after age 19?
Q. What if I forgot to add or cancel an employee’s coverage?

Billing:

Q. When is my premium payment due?
Q. When will I receive my monthly invoice?
Q. Do you offer an Auto Payment option?

Ordering ID Cards

Member Services

Dental Health Education



Web Registration

Can I manage my group’s Delta Dental plan online?
Yes, registering for our online services gives you access to detailed information about your group’s benefits, including viewing your entire enrollment roster. Plus, our enhanced online enrollment feature allows you to quickly and easily add a new employee, change coverage tiers, make demographic changes or order a new or replacement ID card. And, check our message center regularly for any important plan documents or upcoming regulatory changes that may impact your plan.

How do I register?
To begin using our online services, you’ll need to complete the Direct Electronic  Access Agreement. Please return the completed agreement to your Delta Dental account executive for processing. We will provide you with a username and password.

Please Note: It takes approximately two weeks to process a completed Direct Electronic Access Agreement. Until you receive your username and password, please forward subscriber changes and additions by emailing Enrollment Services at enrollment@deltadentalri.com, or by calling 401-752-6234. The fax number is: 401-752-6040.

What type of browser do I need to view my account?
Our online services are compatible with multiple browser platforms, including: Internet Explorer versions 9, 10 and 11, Safari, Chrome and Firefox. We recommend using the latest version of your browser to get the most from our website features.

How can I get a lost password reset?
If you’ve lost or forgotten your online password or username, just contact Enrollment Services at enrollment@deltadentalri.com or by calling 401-752-6234, and they will reset your password/username.

Benefits

What does my group’s plan cover?
One of the benefits of Delta Dental is our total flexibility in plan design, so there is no one answer to this question. To review your group's specific benefits, just log on to the Employers section of our website with your assigned User ID and password. There you'll find a comprehensive overview of your plan design, including deductible, coinsurance and maximum amounts, complete employee lists by division and also plan details for any previous coverage period(s). For more information about our plans and products, please click here

Who should I contact to change my group’s covered benefits?
If you’d like to change or upgrade your Delta Dental plan, contact your Account Executive or email: accountservices@deltadentalri.com.

Does the Affordable Care Act (ACA) affect my group’s dental benefits?
On January 1, 2014, the federal Affordable Care Act went into effect, requiring that health plans offered by employers with 50 or fewer full-time equivalent employees offer 10 "Essential Health Benefits," including pediatric dental. Delta Dental has incorporated the required pediatric benefits into all of our plans for small businesses, and will provide the group with a "reasonable assurance" certificate to show that the plan satisfies the pediatric dental requirement of the ACA.

At this time, employers with 50 or more full-time equivalent employees are not required to make any changes to their current Delta Dental coverage under the health care reform statute. We will continue to monitor local and federal regulations and alert large and small employers of any changes that may impact their coverage. Click here to learn more about health care reform and dental benefits.

What are Essential Health Benefits?
The ACA contains 10 health benefits that all health insurance plans are required to cover for individuals and small group markets. Essential health benefits must include items and services within the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care

What does the Pediatric Essential Dental benefit cover?
The Affordable Care Act contains 10 essential health benefits that all health insurance plans are required to cover for individuals and small group markets. Pediatric dental benefits are one of the 10 essential health benefits. For more information, click here.

Who is eligible for Medically Necessary Orthodontia under the ACA?
This unique benefit provides orthodontic services for children with serious orthodontic impairment resulting from congenital abnormalities that affect their daily ability to function, e.g. eating, speaking, etc. Under the ACA provisions, there are no lifetime or annual maximum limitations for medically necessary orthodontia, which is covered at 50%* Click here for more details.

Eligibility

When can I enroll a new employee?
You can add a new employee to your group’s coverage at any time by using our Online Enrollment feature. Contact your Delta Dental Account Executive for more information.

How do I change an employee’s coverage status from individual to family?
The only time you can add or delete employees other than during open enrollment is for a new hire, a terminated employee, or during what’s called a qualifying event. Reasons include:

  • Marriage
  • Full-Time/Part-Time Status
  • Spouse’s Loss of Coverage
  • Birth or Adoption
  • Divorce
  • Death of a Member
  • Family Medical or Disability
  • Workers' Compensaton Leave

Who is covered on a family plan?
Typically, an individual membership covers the employee only. A standard family membership covers the employee, their spouse, dependent children until they turn age 19 (or age 26, depending on your plan’s eligibility rules), and handicapped dependent children over age 19, who are mentally or physically incapable of earning their own living.

Are dependents covered after age 19?
Dependents over age 19
Dependent coverage varies by group. Some employers have elected to follow the new health care reform requirements and extended dependent coverage to age 26. In this situation, we do not need any additional documentation for dependents over age 19.

Student Coverage

Some employer groups offer dependent coverage for either full-time or part-time students (or both) up to age 26. Fill out the Student Certification Form if you are certifying dependents as college students. If you are a State of Rhode Island Employee, you'll need to fill out the Student Certification Form for State of Rhode Island Employees and provide the following documentation to certify your student:

  • A copy of the students fall tuition bill, or
  • A letter from the school's registrar stapled to this form, or
  • The school's stamp or seal affixed

If your group has selected student coverage, we will provide you with a list of employees with dependents who are eligible to continue coverage under your plan, or those with dependents who have reached your group’s maximum age for students. You do not need to send a notice to your employees. We will do that on your behalf and then send you a list of students whose coverage has ended so that you can proceed with any applicable COBRA notifications

What if I forgot to add or cancel an employee’s coverage?
Delta Dental has a 30-day retroactive policy for adding or canceling employees from your plan. Retroactivity occurs when we are notified of an addition, change or termination after the requested effective date has passed. However, if we paid a claim after the requested retroactive termination date, your employee will be terminated on the last day of the month in which the claim was paid.

Billing

When is my premium payment due?

Payment is due in advance on the first of each month to cover that month’s premium.

When will I receive my monthly invoice?

You’ll receive a monthly invoice approximately 10 days before the first of the month, reflecting current and prior billing information, payment information from the prior month, and any reported eligibility changes. Your invoice shows a cutoff date for any enrollment and payments received.

Do you offer an Auto Payment option?
Yes, you can have your monthly premium automatically deducted from your bank account, saving your group from coverage lapses, late payments and monthly check writing.

To begin, download the Automatic Payment form. Mail the completed form to:

Delta Dental of Rhode Island
10 Charles Street Providence, RI 02904
ATTN: Accounts Receivable Department

Or fax the form to: 401-752-6200

For any questions, contact Billing Services at 401-752-6200 or 800-598-6684.

Ordering ID Cards

The fastest way to order an ID card for a new employee or a replacement card for a current employee is through our Online Enrollment feature.   Please allow five to 10 days for processing and mailing. If the new employee has an upcoming dental visit, you can always print a paper card directly from the website. We provide one card for individuals, and two cards for family plans. All cards are issued in the name of the subscriber, not the member.

Member Services

Delta Dental offers your employees and their eligible dependents access to all the tools they need to manage their dental coverage, both online and through our Automated Call Center. Both our online and automated phone services are available 24 hours a day, 7 days a week, providing detailed benefits and eligibility information, claims status updates and more. For more complex service questions, our friendly, knowledgeable Customer Service representatives are available Monday through Thursday, from 8 a.m. to 7 p.m. and Fridays from 8 a.m. to 5 p.m., ET. By phone:  401-752-6100 or 1-800-843-3582, or email at: customerservice@deltadentalri.com.

What dental health information do you provide to members?
One of our most important tools in providing pricing information to dentists and employees alike is the pre-treatment estimate. A pre-treatment estimate lets the dentist and employee know - in advance - whether or not a particular service will be covered under the employee's plan. We recommend pre-treatment estimates for any service that is expected to cost $300 or more. Our participating dentists are familiar with this process and typically request these estimates on behalf of their patients. For services that your dental plan does not cover at 100% (e.g. crowns, bridges and certain surgical procedures), having a pre-treatment estimate lets your employees know what their out-of-pocket costs will be. Our participating dentists are familiar with the pre-treatment process and we also provide this information to members online and in print with our “Smart Choices” educational series.

Dental Health Education

Our website offers information on a range of dental health topics, from brushing and flossing tips to the importance of good nutrition for your oral health. Click here to link to our full oral health library. And don’t forget to share our quarterly dental health magazine, GRIN!, with your employees for the latest fun and educational facts and tips. Click here to view the current issue.