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Wisconsin Department of Employee Trust Funds header image It's Your Choice 2017 State of Wisconsin Group Health Insurance Program
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2017 It's Your Choice - State of Wisconsin Group Health Insurance for Employees and Retirees

Wisconsin Department Of Employee Trust FundsIt's Your Choice 2017


State of Wisconsin
Group Health Insurance Program
(State Employees, Retirees, Continuants and Graduate Assistants)

Uniform Dental Benefits

If you have medical coverage under the State of Wisconsin Group Health Insurance Program, you have the option to elect Uniform Dental Benefit plan coverage. If you are currently enrolled in the Uniform Dental Benefit plan, you will remain in the plan unless you decline coverage during the It's Your Choice open enrollment period. New employees choose health insurance, with or without dental, during the application process.

Delta Dental is the plan administrator.

Questions? Visit www.deltadentalwi.com/state-of-wi or call Delta Dental at 1-844-337-8383.

Uniform and Supplemental Dental

Uniform Dental Benefits are only available if you enroll in a health plan. Supplemental dental insurance (e.g., EPIC Benefits+, EPIC Dental Wisconsin, Anthem DentalBlue) are separate, optional plan offerings.

Premium Contributions

The dental premium will be included in your medical health insurance premium. You will not see a separate deduction on your paycheck for Uniform Dental Benefit premiums.

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.

Search Dental 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 covered under the Uniform Dental Benefit, 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 2017.

See more Uniform Dental Benefits (Certificate of Coverage).

 

Benefit In-Network Coverage Examples and Limitations of Covered Services
Deductible $0  
Annual Benefit Maximum $1,000 per member  
Diagnostic/Preventive/Basic Services 100% Exams, cleanings, X-rays, fluoride, sealants, fillings
Orthodontics 50% Lifetime maximum of $1,500 per member; children under 19 years of age only


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: 9/20/2016 5:31:26 PM