Employee Matters
The Employee Compensation and Benefits Services staff prepares this column.
Coordination of Dental Benefits
Choosing the right dental coverage can be confusing. University employees may have dental benefits under several plans:
- HMO health plans may include routine preventive dental
- The Dental & Excess Medical plan (administered by EPIC) provides supplemental dental coverage
- Represented or Non-Represented dental plans.
What dental coverage is provided with an HMO health plan?
All Dane County HMOs cover all or part of routine care, such as cleanings and exams. More inclusive coverage varies by HMO. For more detailed information, see section G of “It’s Your Choice” dual-choice book. The Standard Plan does not include dental benefits.
What dental coverage does the Dental and Excess Medical plan provide?
This plan covers a portion of the cost for restorative or comprehensive care, not routine care. Benefits of this plan coordinate well with the HMO health plan benefits.
What is the difference between the Represented and Non-Represented dental plans?
Represented employees are offered dental programs through their union, whereas the Non-Represented dental plan is sponsored by UW System Administration.
Why are there three Non-Represented Dentacare plans?
Each plan fills a specific niche. Dentacare HMO and Preferred PPO plans include routine and comprehensive coverage and are designed for employees whose health insurance plan does not include dental benefits. The HMO requires use of a Dentacare Center, while the more flexible PPO allows use of any dentist. The supplemental plan, which is less expensive, is intended for employees whose health plan includes dental benefits and allows using any dentist.
What coverage coordinates with the Standard Plan?
Good choices would be the Dentacare HMO or PPO plans, as they include full coverage including routine care. Consider the Dental & Excess Medical in addition to the HMO or PPO if you have dental expenses above and beyond the costs covered by these plans. If you select the Dental & Excess Medical plan only, remember it does not cover routine care.
If I have an HMO health plan, do I need additional coverage?
If you want comprehensive coverage for restorative work, such as bridges, crowns, root canals, dentures and additional orthodontia, you will need coverage above and beyond your HMO.
How do I choose between the Non-Represented Dentacare Supplemental and the Dental and Excess Medical plans?
Only non-represented unclassified and classified employees (including LTEs covered by the Wisconsin Retirement System) are eligible for the Non-Represented Dentacare plan. All employees eligible for health insurance are eligible for Dental and Excess Medical. Next, compare the premiums and coverages.
If I have more than one plan with dental benefits, how is coverage coordinated?
If you have benefits under all three plans, your HMO will pay benefits first, Dentacare pays second, and Dental & Excess Medical pays last.
Is there any way to reduce the cost of dental services without enrolling for dental coverage?
Yes, money can be set aside before tax in an Employee Reimbursement Account (ERA) if you have predictable expenses. See the annual enrollment information.
Where can I find more information?
Find more information on your employee Web site at: http://www.bussvc.wisc.edu/ecbs/emp-insurances-menu.html.