Delta Dental Plan Options
for Massachusetts Students
2015-2016 Policy Year
Dear Massachusetts Students,
We are pleased to offer Massachusetts College and University students and their dependents a choice of two dental insurance plans (DeltaCare and Delta Dental PPO Plus Premier). You may enroll in these plans on a VOLUNTARY basis; they are not required insurance.
The enrollment deadline for coverage effective 1/1/16-8/31/16 is December 15, 2015.
As with any insurance plan, please make sure that you have read the Plan Highlights & Benefit Information before enrolling in either dental plan. The copayments on the DeltaCare flyer and the PPO Plus Premier flyer are subject to change. The most up-to-date copayment schedule can be found on www.universityhealthplans.com at any time during the policy year.
PLEASE NOTE THE FOLLOWING BENEFIT CHANGES EFFECTIVE 7/1/15 FOR THE PPO PLUS PREMIER PLAN:
- The calendar year maximum has changed to $1,000 per person.
- The plan co-insurance for Diagnostic and Preventative services received from a Premier or Out-of-Network provider has changed to 80%.
The premium cost for each coverage option is as follows:
|DeltaCare||PPO Plus Premier|
|Student & 1 Dependent:||$413.00||$663.00|
|Student & 2 or more Dependents:||$621.00||$991.00|
Students and dependents who wish to enroll in one of these plans MUST submit the online enrollment form and pay the full premium amount online via credit card no later than midnight on the posted deadline for their selected coverage period. The enrollment deadline for coverage effective 1/1/16-8/31/16 is December 15, 2015.
Please note: As part of the enrollment process for the DeltaCare Dental Plan, you (and any dependents you choose to enroll) must select a DELTA CARE Primary Care Dentist (PCD). If you do not choose a DeltaCare PCD, Delta Dental will choose one for you that is closest to your area. Your enrollment form will not be accepted without this election. Please refer to the participating provider list on the website for a complete, up to date, list of participating providers. The PPO Plus Premier Plan does not require enrollees to select a primary card dentist.
IMPORTANT: Please review the Plan Highlights & Benefit Information for both dental plans offered to you BEFORE enrolling in either. Refer to the FAQs for an overview of the main differences between the two plans.
Should you have any questions regarding the enrollment process, please contact University Health Plans via email at email@example.com or at 800-437-6448.