Franklin Pierce University

All full-time employees are eligible to enroll in the University's dental insurance plan on the first day of the month following thirty days of employment with the University.

Dental care coverage is currently provided by Northeast Delta Dental. The University reserves the right to change insurance carriers and/or make plan design changes at the conclusion of any plan year.

Participating Dentists' Network
You'll get the best value from your program when you receive your dental care from one of Northeast Delta Dental's Participating Dentists:

No Balance Billing: Because participating dentists accept their usual filed fees for service, you will normally pay less when you visit a participating dentist.

No claims processing: Participating dentists will prepare and submit claims for you.

Direct payment: Northeast Delta Dental pays the dentist directly, so you don't have to pay the covered amount up-front and wait for a reimbursement check.

To find out if your dentist is part of the Northeast Delta Dental network, call your dentist or visit our web site at www.nedelta.com

Claim Process for Participating Dentists

Present your ID card to the dentist at the time of your visit.

The dentist will submit your claim to Northeast Delta Dental.

Northeast Delta Dental will send you a NOB (Notification of Benefits) detailing what has been processed under your programs coverage. You are responsible to pay any remaining balance directly to the dentist.

Non-Participating Dentists

Delta Dental provides coverage regardless of the patients' choice of dentists, participating or not. When visiting a non-participating dentist, the patient may be required to submit the claim to Northeast Delta Dental and pay for the services at the time they are provided. Payment for services rendered by non-participating dentists will be based upon the amount that the majority of participating dentists charge for those services. The NOB and claim payment will go directly to the subscriber. The patient will be responsible for any remaining balance.

Out-Of-Tri-State Area

Delta Dental provides coverage for treatment received outside of Vermont, New Hampshire, and Maine. When visiting a dentist outside the area, the patient may be required to submit the claim to Northeast Delta Dental and pay for the services at the time they are provided. Payment for services rendered will be based upon the Plan's allowance for non-participating dentists. The Notification of Benefits and claim payment will go directly to the subscriber. The patient will be responsible for any remaining balance.

Predetermination of Benefits

Northeast Delta Dental strongly encourages predetermination of cases involving costly or extensive treatment plans. Although its not required, predetermination helps avoid any potential confusion regarding Delta Dentals payment and your financial obligation to the dentist.

Coordination of Benefits

When a covered individual under this program has additional group dental coverage, the COB (Coordination of Benefits) provision described in your Dental Plan Description booklet will determine the sequence and extent of payment. If you have any questions about COB, please contact our Customer Service department at 1-800-832-5700 or 603-223-1234.

Identification Card

Two identification cards from Delta Dental will be produced and distributed shortly after your enrollment. Both cards are issued in the subscriber's name, but can be used by everyone covered under the program.

Who is Eligible?

All eligible employees and their dependents, defined as:

Spouse or domestic partner

Unmarried, dependent children to age 19

Unmarried, full-time dependent students to age 25

Incapacitated dependent children, regardless of age.

**If enrolling one eligible dependent, all eligible dependents must be enrolled unless they are covered elsewhere.

Guarantee Of Service Excellence™ Program

Northeast Delta Dental is committed to providing extraordinary service to all of its customers. We believe that when our people are inspired to pursue excellence in order to achieve a higher level of customer satisfaction, all of those who share in Northeast Delta Dental will benefit. To emphasize our commitment, we guarantee seven major areas of service to our clients and reinforce them by our comprehensive group refund policy. More information.

***This information should be used only as a guideline for your dental benefits program. For detailed information on your group's terms, conditions, limitations, exclusions and guarantees, please refer to your Dental Plan Description booklet or consult your employer.

Domestic Partner Benefit ~ Dental

Effective January 1, 2006, medical, dental and vision Insurance benefits will be available to domestic partners and their legal dependents on the same basis that they are available to legal spouses and the legal dependents of those spouses. For specific information about insurance eligibility, refer to the Domestic Partnership policy or contact Human Resources.

Insurance Enrollment

To add a domestic partner and/or the partner's dependents to your coverage, you must complete an affidavit of domestic partnership and submitted along with the appropriate insurance enrollment application or change/enrollment forms.