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PPO (Preferred Provider Organization) providers participate in the network thereby agreeing to accept contracted fees as payment in full rather than their usual fee for patients. When you visit a PPO provider, you typically pay a certain percentage of the reduced rate (called coinsurance) and the plan pays the rest.
A Dental Health Maintenance Organization (DHMO) plan requires you to choose one dentist or facility to coordinate all of your oral health needs. If you need to see a specialist your primary care dentist will provide a referral. A DHMO plan doesn’t have any deductibles or maximums and you pay a fixed dollar amount for any treatment (a “copayment”). However, if you visit a dentist outside of the network, you will be responsible for the entire bill. Watch the video below for further details on Delta Dental’s networks.
An annual maximum is the maximum dollar amount a benefit plan will pay toward the cost of care within a specific benefit period, usually a calendar year.
The portion of the cost of your treatment that you are required to pay.
A specific dollar amount that you must pay before the plan begins to cover your expenses.
This is a document you receive from your insurance carrier after you visit the provider. It is not a bill, but rather an explanation of what procedures were performed and what was covered by your plan. These documents may vary with different insurance providers but should include the provider’s fee, the portion your insurer paid and any amount you may owe (such as deductible, coinsurance or non-covered services). It should also include an update on how much of your annual maximum has been used and the amount you’ve paid toward your deductible.
A qualifying life event includes a change in marital status (marriage or divorce), the birth of a child, adoption of a child, or loss of other coverage. You can enroll under a qualifying life event up to 60 days after such an event. If you miss that window, you will have to wait for the next available open enrollment period. If you have a qualifying life event, please contact the Member Support Team at (877) 247-8817.
View the Member Connection flyer to find out how to register. Visit the Member Connection site where you can access benefits, eligibility, and claims information for your plan.
Once premium has been paid and your policy is in-force, there will be no cancellations, refunds, or early termination of coverage. There is a $25 fee for issues related to payment via check or electronic processing.
Benefit Partners Technology administers the enrollment and payment process. If you have any questions, please contact the Member Support Team toll-free at (877) 247-8817.
For questions about benefits or claims, please visit the Contact Us page of this website for carrier specific contact information.
If you have any questions about the 401(k) plan please contact our Retirement Plan Services Team (847) 247-8811.
You may enroll in an Affordable Care Act compliant plan through the Marketplace and we can assist you with a possible tax subsidy. If you are looking for group insurance, we will work with you to obtain quotes from all of the national carriers. For more information contact our Member Support Team at (847) 247-8811.