Q: With DDWA offices closed, will customer service and claims processing still operate?
A: Yes. We are committed to ensuring our customers receive the care and services they need.
Although our offices are closed, our teams continue to work remotely. We are doing all we can to keep our customer service team available to you by phone at 1-800-554-1907.
We continue to meet all of our claims turnaround service levels:
- Claims paid in an average of 3.7 days after receipt
- 90% of claims submission are received electronically
- 80% of those claims are processed automatically
Q: What emergency procedures are allowed? When should employees or members seek care?
A: We’ve written a blog post about this issue for all our members. Read here
The American Dental Association has also developed a guide for emergency dental procedures. This guidance may change as the COVID-19 pandemic progresses. The guide can be found here
Q: What if a dentist isn’t offering emergency care?
A: Members’ whose regular dentist offices are closed can also use the DentistLink service. It can connect them with dental providers in their area who can provide urgent care. People needing help can call or text DentistLink at 844-888-5465. More information
Q: Are you extending the premium grace period for groups and individuals members?
A: Yes, although we are not mandated to do so by the Office of the Insurance Commissioner, we are extending plan premium grace periods to 60 days for all fully-insured, pooled, negotiated groups as well as individual and family plan members.
Q: Are you extending self-insured claims payment grace?
A: We don’t expect any significant volume of claims due to the fact that non-essential appointments are being postponed.
The lower volume of claims should help large businesses manage claims calls.
Any employer that anticipates a hardship due to self-insured claims payment should reach out to their account management team.
Q: What are you doing to support a tele-dentistry option?
A: From a coding and claims perspective, we do not differentiate between in-person or tele-dentistry services.
Providers can submit the same code regardless of environment and it will be paid accordingly if the benefit is covered.
Q: Can employers waive leave of absence?
A: Yes. Eligibility is determined by the group, and as a result, we can waive the minimum hour requirement for benefits of existing full-time employees.
Q: What is your policy on furloughed employees?
A: The group determines eligibility for members. Our standard contractual language states, “A full-time employee is an employee who works a minimum of 80 hours each calendar month or as otherwise determined by the group.”
The flexibility of the standard language allows each employer to set their eligibility standards without impacting documentation with us.
We will support any eligibility decisions and work with you to document those changes if needed.
Q: Are you offerings premium “holidays” to clients impacted by COVID-19?
A: We are prevented by current regulation from offering premium holidays, rebates or waivers to our groups.
The Washington State Office of Insurance Commissioner has assembled information on how COVID-19 impacts insurance, and other helpful resources for business assistance.
Q: Can a group term for one or two months and come back to the same plan, rates, etc.?
A: A group can term their members, and if they return within the same contract period, we will allow employees to pick up where they left off meeting deductibles and annual maximums.
Q: Are employees who are below the minimum number of hours required eligible for benefits?
A: Yes. Eligibility is determined by the group, and as a result, we can waive the 30 hour per week requirement for benefits for existing full-time employees.
Q: If groups have reduction in staff, will their rates change?
A: Our rates will not change due to a reduction in staff. They will stay in the same size tier as their current contract. Rates will also not be adjusted mid contract if a group has a reduction in staff during this time.
Q: What if a majority of the employees are in COBRA and not active status?
A: We will administer the benefits in the same way whether employees are sent as active or COBRA.
Q: When an employer lays off employees, when does their coverage end?
A: Coverage remains effective through the full month of paid premium.
Q: How will negotiated groups’ renewals be treated if they are temporarily below 99 due to COVID-19 at time of renewal?
A: Groups will remain in our negotiated group segment for the next renewal term.