Overview

If you enroll in health insurance under the State Group Health Insurance Program, you have the option to elect the Uniform Dental Benefit. Employees choose health insurance, with or without dental, during the enrollment process.

Delta Dental of Wisconsin is the plan administrator of the Uniform Dental Benefit.

Eligibility

The Uniform Dental Benefit is only available if you enroll in the State Group Health Insurance program. If you elect family health insurance with dental, you will be enrolled in family uniform dental insurance. Similarly, if you elect single health insurance with dental, you will be enrolled in single uniform dental insurance.

Coverage

Below is the schedule of benefits covered by Uniform Dental. You must use a Delta Dental PPO or Premier provider.

Uniform Dental provides coverage for diagnostic, preventive and restorative services (such as fillings).

Uniform Dental does not include coverage for major dental services, such as crowns, root canals or implants. If you want coverage for major dental services, you may want to enroll in one of the supplemental dental plans with Delta Dental. You do not need to enroll in Uniform Dental in order to enroll in one of the supplemental dental plans.

Uniform Dental Benefits Coverage
Deductible None
Annual Benefit Maximum $1,000 per member
Diagnostic and Preventive Services

Routine evaluations, dental cleanings, bitewing and panoramic X-rays, fluoride treatments, sealants, fillings

100%
Basic Services

Local anesthesia, emergency pain relief

80%
Major/Restorative Services

Crowns, bridges, dentures, root canal therapy (endodontics)

Not covered
Orthodontics (Under Age 19)

Coverage

Lifetime Maximum

Waiting Period

 

50%

$1,500

None

Dental services covered by Uniform Dental are not subject to the health insurance deductible. See the Uniform Dental Benefit (Certificate of Coverage) for a list of covered services and exclusions.

Note: ID cards for Uniform Dental are separate from the ID cards for Supplemental Dental. If you enroll in both, Uniform Dental and Supplemental Dental, bring both ID cards with you to your appointment.

Provider Network

Delta Dental has two provider networks available under the Uniform Dental benefit: Delta Dental PPO and Delta Dental Premier. To receive coverage for dental services, members must choose a dentist within one of Delta Dental’s networks. Delta Dental’s PPO network provides the richest discounts to services. There is no benefit for out-of-network providers.

See the Delta Dental Network Reference sheet for more information on the two provider networks.

Not sure if your dentist is in one of the networks? Call Delta Dental at 800-236-3712, visit Delta Dental at deltadentalwi.com/state-of-wi or contact your dentist directly.

Benefit Premiums

For Uniform Dental premiums, see the Premiums page.

Forms & Resources

last updated: 05/31/2019

Every effort has been made to ensure this information is current and correct. Information on this page does not guarantee enrollment, benefits and/or the ability to make changes to your benefits.