Frequently Asked Questions

After I enroll in the program, will I receive any communications from Delta Dental?

Yes. If you elect the PPO option, within approximately 14 business days from the date OCC Human Resources enters your enrollment in the Delta Dental eligibility system, you will receive an email from Delta Dental welcoming you to the program. The email will contain links to this website and to the Consumer Toolkit, which allows you to print your ID card and access other program information.

If you elect the DHMO option, Delta Dental will mail you a welcome packet that will include your DHMO ID card and information regarding the DHMO option in your area.

What is my ID number under the program?

If you are enrolled in the PPO option, your ID number is currently your Social Security number. Before the end of 2015, the program will implement the use of an alternate ID number which will be assigned to you by Delta Dental and you can use this number instead of your Social Security number. You will receive notification when the alternate ID is ready for your use.

If you are enrolled in the DHMO option, you are assigned a unique ID referred to as your Enrollee Number that you can use when making a dental appointment, when contacting Delta Dental’s customer service department and when registering on the Delta Dental website.

I just discovered that my dependent child is not enrolled under my plan. When can I add my child?

If you did not enroll your spouse or child when they were first eligible, your next opportunity to enroll them is during Open Season, which takes place in the fall. Contact the OCC Human Resources department for the exact dates of the next Open Season.

When can I change my election from the DHMO to the PPO option?

You can change your election during the next Open Season, which takes place in the fall. The exact dates for the next Open Season will be announced by the OCC Human Resources department.

When will coverage end for my dependent child?

Coverage for dependent children who are unmarried will end automatically at age 22 but can be extended up to their 25th birthday if they are a full-time student pursuing a degree from an accredited college or university recognized by the U.S. Department of Education.

What do I have to do to extend coverage for my child who will be turning age 22 soon and is a full-time student in college?

Approximately 90 days before your child’s 22nd birthday, Delta Dental will send you a notice by email (or by U.S. mail if there is no email address on file) requesting that you provide documentation to verify that your child is enrolled as a full-time student in the spring or fall semester, whichever is applicable. Each subsequent July, Delta Dental will send you a request for documentation verifying that your child is enrolled in the upcoming semester as a full-time student. The annual request to provide student verification will continue until your child graduates, gets married or reaches age 25, whichever occurs first.

Is there an age limit for orthodontic coverage?

There is no age limit for orthodontic coverage under the program as long as you and your eligible dependents remain enrolled.

How many cleanings can I get per year and how often can I go to the dentist under the PPO plan?

Two cleanings are covered in a calendar year. Use the online Consumer Toolkit to help you track your cleanings to date and when you’re eligible for your next one.

Will I pay more out-of-pocket if I receive services from a dentist who does not participate in a Delta Dental network?

Yes. If you are enrolled in the PPO option, you can visit any licensed dentist, but you’ll maximize plan value by taking advantage of Delta Dental’s large PPO network because these dentists have agreed to contracted rates. The Delta Dental Premier® network also provides cost protections for PPO enrollees. Premier dentists’ contracted fees are typically higher than PPO dentists’ fees, but they can usually help you save on out-of-pocket costs. An out-of-network dentist can charge you his or her customary fees for services provided, and you will usually be required to pay the dentist in full as well as to submit your own claims to Delta Dental. Delta Dental will pay for covered services performed by an out-of-network dentist based on the dentist’s usual and customary fees and the plan’s coinsurance amount. However, when you receive services from a network dentist, you are not required to pay the dentist up front (other than your estimated copayment) or to submit your own claims. A network dentist will submit claims to Delta Dental and receive payment directly from Delta Dental based on plan’s contracted fees and coinsurance amount. Also, you will not be “balanced-billed” for any costs above Delta Dental’s contracted fees.

How long does it normally take for Delta Dental to process a PPO claim?

The time it takes to process a claim depends on the type of services performed. Delta Dental processes claims quickly and efficiently—99% are processed within 10 business days. If Delta Dental requires additional information in order to process a claim, it may take longer.

If I am enrolled in the DHMO option and I need to see a specialist, will I have access to one?

Your DHMO contract dentist will coordinate your specialty care needs for oral surgery, endodontics, periodontics or pediatric dentistry with an approved contract specialist. If there is no contract specialist within your service area, a referral to an out-of-network specialist must be preauthorized by Delta Dental.

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