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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2016 State of Wisconsin Group Health Insurance Program
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Wisconsin Department Of Employee Trust Funds It's Your Choice 2016


Local Deductible Plan
Insurance for Employees
and Retirees
(PO4)


Dental Coverage for 2016 tooth

Your employer may choose to offer Uniform Dental Benefits along with your health insurance coverage. Ask your benefits office about available options.

Uniform Dental

You will automatically be enrolled in Uniform Dental Benefits if your employer offers it. (You may opt out by filing an application/change form with ETF.) Uniform Dental Benefits are only available if you enroll in a health plan.

Premium Contributions

Employee premium contribution amounts are determined by your employer. Contact your benefits office for employee monthly premium contribution rates. The dental premium will be included in your medical health insurance premium.

Medical Coverage with Dental

If you elect family medical coverage with dental, you will be enrolled in the family dental coverage. Similarly, if you elect single medical coverage with dental, you will be enrolled in the single dental coverage. You may opt out of Uniform Dental Benefits during open enrollment online using myETF Benefits or by submitting a health insurance application/change form.

Search Covered Providers

Delta Dental has two provider networks available under the Uniform Dental Benefit: Delta Dental PPO and Delta Dental Premier. Providers covered under these networks are considered “in-network” under the Uniform Dental Benefit. You may search the Provider Directory at www.deltadentalwi.com/provider-search/ to see if your dental provider is in a Delta Dental network. There is no benefit for out-of-network providers.

No Dental Deductible

Dental expenses, including those for the High Deductible Health Plan, are separate from medical benefits and will not be subject to a deductible.

Covered Services and Coinsurance

All covered services, copayments and/or coinsurance will be outlined in the Uniform Dental Benefit Certificate and on Delta Dental’s website and enrollment materials. There are no changes to the covered dental services, copayments and/or coinsurance for 2016.

See more Uniform Dental Benefits (Certificate of Coverage).

Disclaimer:
Every effort has been made to ensure that this information is accurate, but may be subject to change. Please note revision dates located at the bottom of each page. In the event of conflicting information, federal law, state statute, state health contracts and/or policies and provisions established by the State of Wisconsin Group Insurance Board shall be followed.

This page was last modified on: 11/4/2015 8:26:34 AM