1-800-553-9536 or 651-406-5916
Monday–Friday, 7:00 a.m.–7:00 p.m.
Enrollments, changes and cancellations can only be made to your plan during open enrollment, May 1-15, unless you have a qualifying life event.* To change or cancel your dental insurance coverage, please complete a Delta Dental Membership Maintenance Form and return to Wendy Carlberg, Benefits. To enroll in the dental plan, fill out the enrollment form.
Visit Delta Dental to view your coverage summary, claims, benefits used to date, search for a dentist and order identification cards.
2019-20 Plan Year (July 1-June 30)
Delta Dental Forms
Delta Dental Enrollment Form (new enrollment)
Delta Dental Membership Maintenance Form (change/cancellation form)
Effective July 1, 2018, dental implant benefits offered.
Delta Dental Plan Information
A qualifying life event* is defined as:
marriage, divorce, or legal separation
birth or adoption of a child
death of a spouse or child
change in residence or work location that affects benefits eligibility for the employee or your covered dependent(s)
your child(ren) meets or fails to meet the plan's eligibility rules (for example student status changes)
you or one of your covered dependents gain or lose other benefits coverage due to a change in employment status (for example, beginning or ending a job)
Adding children to the program
Children may be added to the program at the time the eligible employee originally becomes effective or may be added anytime up to 30 days following the child's 3rd birthday. If a child is born or adopted after the employee's original effective date, such child may be added anytime between birth (or date of adoption) and 30 days following the child's 3rd birthday. In the event that the child is not added by 30 days following his/her 3rd birthday, that child may be added only if there is a family status change or at the next open enrollment period.
The dependent age maximum is age 25.
Questions? Contact Wendy Carlberg, Benefits, Human Resources, St. Francis Area Schools.