Overview

The Uniform and Preventive Dental plans provide coverage for diagnostic, preventive and basic services. You are eligible for either Uniform Dental or Preventive Dental, based on whether you enroll in State Group Health Insurance. Review the eligibility section of this page for additional information.

Delta Dental is the plan administrator for the dental insurance plans.

For more information, review the Plan Brochure and Dental Comparison Chart located in the Forms & Resources section below.

Eligibility

  • Uniform Dental: You are eligible if you enroll in State Group Health Insurance. If you elect family State Group Health Insurance with dental, you will be enrolled in family Uniform Dental Insurance. If you elect individual State Group Health Insurance with dental, you will be enrolled in individual Uniform Dental Insurance.
  • Preventive Dental: If you waive State Group Health or select the Health Opt-Out Incentive, you are eligible for Preventive Dental.

Coverage

Below is the schedule of benefits for Uniform Dental and Preventive Dental.

Schedule of Benefits (Uniform and Preventive Dental Insurance plans) Coverage
Deductible None
Annual Benefit Maximum $1,000 per member
Diagnostic and Preventive Services

Routine evaluations, dental cleanings, sealants*, bitewing and panoramic X-rays, fluoride treatments*, pulp vitality tests, fillings and periodontal maintenance

*for children to age 19

100%
Non-Surgical Extractions (above gumline) 90%
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 Certificate of Coverage available in the Forms & Resources section below for a list of covered services and exclusions.

Uniform Dental and Preventive Dental do not include coverage for major dental services, such as crowns, root canals or implants. If you want coverage for major dental services, you may enroll in a supplemental dental plan. You do not need to enroll in Uniform Dental or Preventive Dental to enroll in a supplemental dental plan.

Provider Network

Delta Dental has two provider networks: Delta Dental PPO and Delta Dental Premier. You must choose a dentist within one of Delta Dental’s networks. Delta Dental’s PPO network provides the deepest discounts for services. There are no dental benefits for out-of-network providers.

Not sure if your dentist is in one of the networks? Call Delta Dental at (844) 337-8383. Or visit Delta Dental at deltadentalwi.com/state-of-wi. Or contact your dentist directly.

Enrollment

You have 30 days from your date of employment or your newly benefits-eligible job to enroll in Uniform or Preventive Dental. Coverage begins on the first of the month on or following your eligibility date. If you do not enroll in Uniform or Preventive Dental within your initial 30-day enrollment period, or want to add/remove dependents from your plan, your next opportunity to do so is during the Annual Benefits Enrollment period (each fall). Otherwise, if/when you have a qualifying life event. See Life Events for more information.

Once enrolled, you must remain enrolled for the entire calendar year.

Benefit Premiums

For Dental Insurance premiums review the Benefit Premiums web page.

Forms & Resources

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.

Updated: 01/02/2024