Eligibility
Employer groups must have two or more full-time employees
enrolled.
Contribution/Participation
The employer must contribute a minimum of 50% of the employee premium.
75% of the eligible employees must participate, 100% must participate if the employer contribution
is 100% of the employee premium. Employees covered by a spouse's group plan
or a union plan
do not have to participate.
Benefit Selections
We have a large variety of plans available. As long as we have 75% of
eligible employees enrolling, any size group can offer a base plan and a buy-up plan if
they wish. Contribution will be based upon the lower cost plan. The
group may mix and match plans to suit their needs.
For example: a group
may wish to offer the PPO Classic 1500 plan as their base plan and allow
employees to buy-up to the Premier 1500 plan.
The VSP C $5 copay plan must have a minimum of 2 enrolling to
be offered.
Benefit options
are selected by the group.
If the group selects to have
Orthodontia and/or the D&P maximum waiver, they must have the
orthodontia and/or D&P maximum waiver option on
all plans being offered and
all members must have the
benefit(s).
The
following plans do not offer Orthodontia: PPO Classic 1000 and
Premier Plan IV.
The following plans do not offer the D &
P maxumum waiver: Premier Plan II, III, IV and the PPO Classic 1000.
Employees
All employees of the employer who are performing active work on a
full time basis (20 hours a week or over) are eligible for benefits including corporate
officers, owners, or partners.
Dependents
All eligible dependents
can enroll on the
original effective date.
Dependents can also be added for a
later effective date if they are newly eligible or as part of an open enrollment
process.
Eligible dependents include legal spouse
or domestic partner and children to age 26.
The employer is responsible to report any changes to a
dependents eligibility to Wolfpack Insurance Services, Inc.
Newborn children do not need to enroll until just before the first
appointment, usually before age 4.
Domestic partners
are defined as same-sex and opposite-sex
couples registered with any government agency authorizing such registrations.
Your domestic partner is subject to the same terms and conditions as any other
Dependent enrolled in this plan.
Open
Enrollment
Any employee who waived off the plan at
initial enrollment may elect coverage on the anniversary date of the groups
enrollment. We can also set the Open Enrollment date to be the same as the
renewal date (see below) or the Open Enrollment date of their group health plan.
Please contact us if you wish to make this change.
Any dependent who did not elect coverage when the plan was established may elect
coverage on the Open Enrollment date.
If an employee who had coverage through their spouse looses that coverage, they may be added the first
of the month after the loss of the other coverage.
Effective date
When a firm joins the Plan, the coverage of its current employees
will be effective on the first day of the month following approval of the firms
application to participate. Additions to your plan will be effective the first of
the month after the elected probationary period from their date of hire.
Renewal Dates
Groups that enroll from January 1st through June 1st renew
on January 1st.
Groups that enroll from July 1st through December 1st renew
on July 1st.
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How to Enroll a
Group
- Complete the
Trust Group
Enrollment Form.
-
Submit
a copy of the latest payroll report.
To
establish the relationship between others (owners or partners) not shown on the payroll,
please click here to download a form
-
If the group
is enrolling in a dental plan and has less than 10 enrolling,
submit proof of prior dental coverage.
(See below regarding the Major and/or
Orthodontia waiting period)
-
Send to Wolfpack Insurance Services, Inc.
using one of the following methods:
Upload Securely
Mail to: PO Box
156, Belmont CA 94002. Or: 425 Harbor Blvd, Suite 2C
Belmont CA 94070.
Fax to: 650-591-4022
Upon approval of the application, the agent and client will each
receive a letter confirming coverage. We will send the Wallet
Cards as directed by the Trust Group Enrollment form.
Billings will be sent directly to the employer
on or about the 8th of the month. Each months
remittance is due on the 25th day of the prior month and will become delinquent if not
received by the 1st of the coverage month. Please make checks payable to Small
Business Benefit Plan Trust or Wolfpack Insurance
Services Inc.
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Can the Delta Dental waiting period for Major
Services and/or Orthodontia be waived?
For groups of less than 10 enrolled
members Delta Dental applies a 12 month waiting period for Major
Services. If the group has the optional Orthodontic Benefit a 12
month waiting period also applies to the Orthodontic services.
We can waive these waiting periods with proof of continuous
prior group coverage for the past 12 months. For the Orthodontic
benefit waiting period to be waived the proof must also show that
Orthodontia was a covered benefit with the prior coverage. Mandated
pediatric coverage under the medical plan does not count towards
waiving the dental waiting periods.
The proof
must be submitted with the enrollment form and will not be accepted
at a later date.
For employee
additions after the groups original effective date proof can consist
of a Creditable Coverage form from the prior carrier or an internet
screen print-out from the prior carrier showing the dates of
coverage and benefits.
Retroactive Member Termination
Member terminations must be
received by the 14th of the month to be terminated retroactive to
the first of the previous month.
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