Carryover Feature for Delta Dental Members

DentalInsuranceNotepad_380x202With the ToGo℠ Annual Maximum Carryover Feature, you can take it with you… 

The ToGo feature from Delta Dental of Illinois allows you to take unused annual maximums “to go” from one year to the next.

In traditional PPO plans, the annual maximum is a “use it or lose it” benefit. The ToGo feature gives you the ability to carryover any qualified unused portion of your annual maximum the subsequent year(s). ToGo provides more flexibility to help you prepare for more extensive and costly dental treatment.

For example, if an enrollee had preventive services this year that totaled to $500 applied to his $1,750 annual maximum, he could carryover $1,250 to next year. This means the enrollee would have the $1,250 ToGo carryover plus the $1,750 annual maximum available next year, offering flexibility to plan for more costly dental procedures.

Enrollees may carry over any qualified portion of their annual maximum benefit, subject to the following guidelines:

  • The enrollee must have been covered under the plan for the full benefit plan year.
  • The enrollee must have submitted at least one claim during the benefit plan year that would apply to his/her annual maximum with allowed dollar amounts that are greater than zero dollars. In other words, the enrollee must have had a dental service that applies to the annual maximum (preventive/diagnostic, basic or major) during the year in order to carryover any unused annual maximum.
  • The carryover amount may not exceed the amount of the annual maximum. Discount Tire’s annual maximum is $1,750, so the total amount of ToGo dollars available cannot exceed $1,750.
  • Enrollees cannot take unused annual maximums with them upon termination of employment or the dental plan, or apply the unused annual maximum to another dental plan.

Example:

Year 1 Year 2
Annual Max: $1,750 $1,750
ToGo bank, carried over from previous year: $0 $1,250
Annual Max + ToGo Bank $1,750 $3,000
Eligible Benefits Received: $500 $850
Unused Annual Max + unused ToGo: $1,250 $2,150
ToGo amount to carry over to next year:
(cannot exceed Annual Max)
$1,250 $1,750

DeltaDentalGet more information on Dental Benefits for full-time employees.

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