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Qualifying Events: How to Enroll in Dental Coverage Outside of Open Enrollment

Many people have dental benefits through an employer or through a government program. Each year, there’s generally a short time period- called open enrollment- to sign up or make changes to your dental plan. But, there are exceptions to the open enrollment period that allow you to make changes in the middle of a plan year.  These are called ‘qualifying events.’

WHAT’S A QUALIFYING EVENT?

A qualifying event is one that changes your life situation. They are generally those big events in life we experience. Some are joyous, like birth of a baby.  Others are not, like a divorce. But they are big changes that allow you to adjust your dental plan.

The most common qualifying events are:

  • Getting married or divorced;
  • Having a baby or adopting a child;
  • Retirement or other end of employment;
  • Losing eligibility under a parent’s plan;
  • Losing eligibility for a government plan like Medicaid;
  • Death of a family member.

WHAT CAN BE CHANGED?

The change must be consistent with the qualifying event.  For example, if you have a baby while you are on a single-person plan, you may change to a family plan and add dependents – like your new family member! – to your plan.

WHEN CAN CHANGES BE MADE?

Generally, the period to make changes is within 30 days for plans with Delta Dental of South Dakota. If the change isn’t requested in time, you may have to wait for the next open enrollment period to make any changes.

Check your plan to see when the change will take effect. For Delta Dental of South Dakota plans, the change generally takes effect on the 1st of the following month.

WHO MAKES THE CHANGES?

If you have a dental plan through an employer, contact Human Resources. In those cases, the employer will need to submit the change to the benefits company.

If you have dental benefits through a government program, contact the benefits specialist from the government agency.

If you purchased a plan directly with an insurance company, contact the company.

HAVE QUESTIONS?

Call us toll free at 1-877-841-1478 if you have any questions about a qualifying event in your life. We’re happy to help!