DENTAL D'S
WHERE YOU WILL USE THIS PLAN
DENTIST
WHAT IS THE NAME OF THE GUIDED WORKFLOW THAT YOU USE TO ASSIST WITH ADDING A DENTAL PLAN?
PLAN SHOPPING
MEMBER WANTS TO ADD A DENTAL PLAN TO EXISTING HEALTH PLAN OUTSIDE OF OPEN ENROLLMENT, WHAT IS NEEDED?
ONE-DAY ADMIN SEP
THE PERIOD OF TIME A MEMBER IS NOT ABLE TO ENROLL IN A NEW DENTAL PLAN WITH A GAP IN COVERAGE
LOCK OUT PERIOD
A MEMBER ON A FAMILY DENTAL PLAN MUST BE UNDER THIS AGE TO UTILIZE THE PEDIATRIC PLAN
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TWO DENTAL PLANS WE HAVE ARE ALTUS AND
DELTA
TRUE OR FALSE: ALL PEDIATRIC COVERAGE HAS AN UNLIMITED ANNUAL BENEFIT PER CHILD.
TRUE
SELECT THIS IN HIX TO GET TO MEMBER PORTAL
MAKE A PAYMENT
MEMBER HAVE 35 DAYS FROM TERMINATION OF DENTAL PLAN FOR NON-PAYMENT TO DO THIS
REINSTATE
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ALL PLANS END ON THE 31ST OF
DECEMBER
WHAT IS THE MAXIMUM OUT-OF-POCKET?
The most a member will pay during the plan year for out-of-pocket cost as the member follows all plan rules including using in-network providers.
AGENT CREATES A NEW PROFILE FOR A NEW MEMBER BEFORE CREATING THIS
ELIGIBILITY APPLICATION
THE 1ST STEP TO TAKE WHEN MEMEBER CALLS TO CANCEL DENTAL PLAN
SEARCH FOR MEMBER
CALVIN HAS A NEW BABY, THE AGENT ADDS THIS FAMILY MEMBER THROUGH
MEMBER PORTAL
SET AMOUNT MEMBER MUST PAY BEFORE CARRIER WILL PAY FOR SERVICES
DEDUCTIBLE
TRUE OR FALSE: DENTAL PLANS CAN BE PURCHASED AT ANY TIME IN THE YEAR. OPEN ENROLLMENT RESTRICTIONS DO NOT APPLY.
TRUE
TRUE OR FALSE: A NEWLY ADOPTED CHILD CAN ONLY BE ENROLLED IN A DENTAL PLAN AT THE BEGINNING OF THE MONTH
FALSE
IF NO SSN AVAILABLE, THIS ALTERNATIVE INFORMATION CAN BE PROVIDED OTHER THAN THE FULL MAILING ADDRESS
SUBSCRIBER ID
CONFIRMING THE HOH ON A FAMILY HEALTH AND DENTAL PLAN CAN BE DONE IN HIX UNDER THIS SECTION
LATEST ELIGIBILITY
NEW MEMBERS MUST WAIT 6 MONTHS TO GET A NEW SET OF THESE
DENTURES
MANAGE DEPENDENTS HERE
MEMBER PORTAL
WHEN COMPLETING AN ENROLLMENT, THE LAST TWO THINGS THE AGENT WILL PROVIDE AS INFORMATION TO A NEW MEMBER PRIOR TO ENDING THE CALL
CONFIRMATION NUMBER & SUMMARY OF CALL
TRUE OR FALSE: TO AUTHENTICATE, A NON HOH DOES NOT HAVE TO PROVIDE THE HOH'S SSN, EVEN IF IT'S ON FILE
FALSE
THESE TWO FORMS ALLOW SPOUSES AND DEPENDENTS TO DISCUSS ACCOUNT AND MAKE CHANGES
ARD & NDF