During the 2024 plan year, participants of the dental plan have an Annual Benefit Maximum of $1,000 per member covered on the plan.
For any subsequent plan years after 2024, members are eligible for a dental rollover benefit. This means that up to $500 of unused benefits from the preceding year’s Annual Benefit Maximum may rollover into the following year, up to a cumulative total of $1,000, in any benefit year.
To qualify for a rollover, the member must meet both of the following:
- All claims paid on behalf of the member during the preceding benefit year must not exceed $750.
- At least one preventive claim for covered dental treatment must have been submitted during the preceding benefit plan year.
Process for granting the rollover:
- Delta Dental will determine if a member is entitled to this rollover benefit of their individual Annual Benefit Maximum based on claims received within three months of the end of the preceding benefit plan year.
- Delta Dental will issue the rollover amount within 120 days after the end of the preceding benefit plan year.
- If a member fails to submit a preventive claim for a covered dental treatment during a benefit plan year, the member will not be entitled to receive the rollover benefit for that benefit year, but the member will retain all previously granted rollover amounts granted within the past three (3) years.
Rollover amounts will expire within three (3) years from when they are granted.