Voluntary Dental Plan for Students, Terms and Conditions

2023-2024 Plan Year

I accept the Delta Dental Student Plan designed for GU students and understand:

I am responsible for the applicable fee and it will be included on my student account
Exclusions and limitations and cost sharing applies
That partial refunds are not granted nor cancellations after Open Enrollment
Plan documents are subject to Department of Insurance Approval and may change as required by law
I am responsible for dental care costs rendered including those not covered as described in the Delta Dental Plan documents
I must accept and may add dependents within the applicable Open Enrollment period
I must include all eligible family members if signing up for dependent membership
A GU administrative fee is included in the rates not to exceed $26/member.
Delta Dental will provide an online account for me to to receive and manage my account and will send notifications to my email address on file in the Registrar’s Office
Delta Dental will provide hard copy notices to me upon withdrawing consent with them to transact business electronically
The submission of an application for the Voluntary Dental Plan for students indicates agreement to these Terms and Conditions for the 23-24 Plan.