Voluntary Dental Plan for Students, Terms and Conditions
2021-2022 Plan Year
Student Agreement To Terms and Conditions Subject to Applicable Student Code of Conduct
I accept the Delta Dental Student Plan designed for GU students and understand:
- I am responsible for the annual 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 $51/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 21-22 Plan.