Policies/Legal
Both plans (CAA54 and CAA55) provide coverage for one year. To enroll yourself or other eligible dependents you pay the annual premium and a one time enrollment fee. You choose your dentist from the online dentist directory during enrollment. Coverage is effective for 12 months and renewal is required to continue coverage.
A full refund of Premium, including the one time enrollment fee, is available if the written request for refund is made within the first month of the Contract Term. Thereafter, requests for Premium refund will be pro-rated based upon the number of months remaining in the Contract Term subject to the following conditions:
- The one-time enrollment fee is not refundable after the first month of coverage.
- You, or your covered dependents, have not received any Benefits under the DeltaCare® USA program.
- There is at least one month remaining in the Contract Term.
- Coverage is based on a full calendar month. There are no partial month refunds.
Coverage for an enrollee will terminate as of the date enrollment is cancelled under the terms of the Disclosure Form/Contract. However, we will continue to provide benefits for completion of any treatment in progress (less any applicable copayment).
Cancellation of enrollment of a primary enrollee will automatically cancel the enrollment of a dependent enrollee. Any cancellation is subject to the written notification requirements set forth in the Disclosure Form/Contract.
If coverage is voluntarily discontinued, you and your eligible dependents may not re-enroll during the 12-month period immediately following the voluntary termination.
Disclosure Form/Contract
Detailed disclosure of plan copayments, limitations and exclusions.
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