DELTA DENTAL PREMIER VOLUNTARY PLAN
The Plan bases coverage on a Table of Allowance that lists all covered services and Delta Dental’s maximum payment for these services. Delta pays either the dentist’s fee or the amount listed in the Table of Allowances-whichever is lower. Monthly premiums for members will be collected through payroll deductions.
(open enrollment/renewal until June 20, 2016)
TO: Pastors, School Principals, and Administrators
FROM: Carol A. Adams, Director of Fiscal Affairs
SUBJECT: Voluntary Group Dental Insurance
DATE: June, 2016
Your employees may participate in the diocesan Voluntary Enhanced Delta Dental Premier program. If you decide to offer the plan to your employees, it must be offered under the same terms, namely, voluntary and 100% paid through payroll deductions. Monthly billing will be sent to the participating entity, e.g. parish school, early in the month with expectation that the bill will be paid before the end of the month. If payment is not received by the end of the month, participants will be terminated from the plan and not allowed to re-enroll in the plan.
The monthly rates are: (1) Individual - $39.00 (2) Individual plus one - $78.00 (3) Family - $110.00. Proportionate deductions should be based upon the employee’s pay schedule.
The renewal date for the voluntary group dental insurance is July 1, 2016 A deadline of June 20th has been set for responses for new enrollment or changes in the dental insurance plan. If a current participant will continue coverage without any changes, no forms need to be completed or returned.
The following documents are attached for your use:
Please return as soon as possible your completed and signed authorization and enrollment forms to:
Sister Joan Pollock
49 Elm Street
Worcester, MA 01609
If you have any questions regarding the dental insurance, please contact Sr. Joan at 508-929-4343.