Updated September 1, 2013
You are eligible to enroll in one of three Delta Dental PPO Premier Plus plans. For most eligible faculty and staff, Berklee subsidizes the cost of coverage by paying 65 percent of the premium, while you pay the remainder through pre-tax payroll deductions via Berklee's Section 125 Cafeteria Plan.
Delta Dental Option I: Low Option
This plan provides coverage for preventive services at 100 percent (deductible is waived) and for basic services at 80 percent after a $25 deductible per individual or a $75 deductible per family per year. Each covered member is eligible to receive up to $750 in benefits per calendar year. There is no coverage for major services or for orthodontic services through this plan.
Delta Dental Option II: Medium Option
This plan provides coverage for preventive services at 100 percent (deductible is waived), for basic services at 80 percent, and for major services at 50 percent. Basic and major services are covered after a $25 deductible per individual or a $75 deductible per family per year. Each covered member is eligible to receive up to $1,000 in benefits per calendar year. There is no coverage for orthodontic services through this plan.
Delta Dental Option III: High Option
This plan provides coverage for Preventive Services at 100 percent (deductible is waived), for basic services at 80 percent, for major services at 50 percent, and for orthodontic services at 100 percent. Basic and major services are covered after a $25 deductible per individual or a $75 deductible per family per calendar year. Each covered member is eligible to receive up to $2,000 in benefits per year. Orthodontic coverage is available for members of any age with coverage subject to a lifetime maximum of $2,000 per covered member.
Enrollment and Member Benefits
When to Enroll
You may enroll yourself and eligible family members within 30 calendar days of your hire date (or if later, the date you become eligible for coverage). If you miss this deadline, your next opportunity to enroll will be during the annual open enrollment period. Open enrollment period selections become effective on January 1 of the upcoming calendar year.
Family Members You May Enroll
- Your spouse (legally married, same or opposite sex). A copy of marriage certificate is required.
- Your same-sex domestic partner (if you live in a jurisdiction where you cannot marry). An affidavit of domestic partnership is required.
- Your children under age 26. A copy of a birth certificate or similar document required.
Special rules apply to certain children who are not your children by birth and to ex-spouses after divorce. Contact the Office of Human Resources for more information.
Enrollment Effective Date
The enrollment effective date is the first day of the month following your hire date (or, if later, the date you become eligible for coverage).
When to Start Using Your Dental Insurance ID Card
You will receive dental insurance ID cards from Delta Dental approximately three to four weeks after you have completed the enrollment process. As a result, although your coverage will be effective the first of the month, you might not receive your cards until later. If possible, contact Delta Dental member services before scheduling your first appointment. If you need dental care services before you receive your dental insurance ID card, you and your dentist may contact Delta Dental member services for proof of coverage.
Changing Your Coverage
Except during your initial 30-day enrollment period or during annual open enrollment, federal regulations prohibit you from enrolling in, canceling, or changing your participation in the plan unless you experience a qualifying life event. Examples of these events include marriage, divorce, birth of a child, and loss of non-Berklee insurance. Any change must be consistent with your qualifying life event. The deadline for making these changes is 30 days from the date of the event.
When Coverage Ends
Generally, insurance coverage for you and your covered family memebers ends at the end of the month when your employment (or eligibility) ends. However, your children's coverage could end sooner. The last day of coverage for children is the day before their 26th birthday, unless they are certified as disabled and eligible for continued coverage. Any person whose coverage ends is eligible to continue that coverage for a period of time via COBRA. Additional COBRA information can be found here.
Delta Dental Member Services
Call 1-800-872-0500 or visit the Delta Dental website.