FAQs
Some Frequently Asked Questions
Q. How many employees must my company have to qualify?
A. This program is available to employer groups with a minimum of 3 employees, to a maximum of 99 employees under the Delta Preferred Option (PPO) and a maximum of 149 employees under the DeltaCare (DHMO) option.
Q. Which employees are eligible?
A. All full-time, permanent employees who work a minimum of 24 hours per week are covered under this program. New hires must wait three months before their coverage begins, or as mirrors your group-sponsored medical plan. Contract employees (category 1099 employees) are not eligible. If a company’s group medical plan uses a definition of at least 20 hours per week, the same definition may be used for this dental plan or vision plan.
Q. Is my company eligible?
A. Most industries do qualify, although some have been excluded (for example, companies that hire seasonal employees). To make sure your company qualifies please refer to our list of eligible industries. The SIC table lists eligible industries.
Q. What portion of the cost are employers required to contribute?
A. We’ve designed this program for employers who will contribute 100% of their employees’ premiums, and at least 50% of dependents’ dues. An employer may choose to make less than 50% of dependent premiums, however, 75% of eligible dependents must enroll for a contract to be issued.
Q. Does Élan have a rate guarantee?
A. Yes, your rates are guaranteed for one year, for each employer.
Q. Can I offer a choice of more than one dental program to my employees?
A. Yes, DeltaCare program may be offered alongside the PPO program DeltaPreferred Option. When offering dual choice programs, there MUST be at least 3 enrollees in DeltaPreferred Option and 3 enrollees under DeltaCare.
Q. If presenting dual choice (Star & DPO) to include Ortho, what is the number of employees required?
A. A minimum of 25 employees must be enrolled in the DPO Plan.
Q. Must I enroll all our employees dependents?
A. No. However, if eligible dependents do not enroll when they become eligible, they cannot enroll at a later date unless they show proof of loss of coverage under another group dental program.
Q. When are new dependents eligible to enroll?
A. When new dependents become eligible, they must be enrolled on the first day of the month following their eligibility as dependents. However, dependent children up to four years of age may be enrolled at the beginning of any contract year, including the contract year immediately following their fourth birthday.
Q. When are existing dependents eligible to enroll?
A. Eligible dependents must enroll at the same time as the primary enrollee.
Q. What happens if a dependent who has dental coverage under another program loses that coverage?
A. Eligible dependents who lose their existing dental coverage must be enrolled with Élan the first day of the month following their loss of coverage.
Q. What are the age limits for dependent children?
A. Dependent children are covered to age 19. If they are full-time students, their coverage is extended to age 23.
Q. When can one of my employees terminate a dependent’s coverage?
A. Once a primary enrollee’s dependents are enrolled, contributions for these dependents must continue to be made by the primary enrollee until one of the following occurs (whichever is earlier) (a) the primary enrollee’s coverage terminates, or (b) the dependent is no longer eligible, or(c) the dependent enrolled is covered under another dental program.