Smile, your dental insurance is fully covered as part of your benefits package. All you need to do is pick a plan and enroll. Once you enroll, you don’t have to pay a monthly premium and coverage is automatic.
Because everyone has different dental needs, we provide you with three different dental plans to choose from:
- Willamette Dental Group
- Uniform Dental Plan (UDP)
To choose the best plan for you and your family, use the information on this page to compare the different provider networks and costs of each plan, or review the Health Care Authority’s 2017 Dental Benefits Comparison chart.
There’s one thing to note as you get started – the plan names can get a little confusing. Both DeltaCare and UDP are administered by Delta Dental of Washington. You’ll find both plans on the Delta Dental website. But when searching for a dentist, make sure you know the plan network and group number; then use that information to verify that a dentist accepts the insurance.
Enroll or change plans
You’re eligible to enroll in a dental plan if you meet eligibility requirements for PEBB insurance. New employees must pick a plan and enroll within 31 days to avoid delayed coverage.
If you already know which dental plan you want, see enroll in a health plan.
If you’re already enrolled but wish to change plans, you can do so during open enrollment or under other certain circumstances. For details, see change your medical or dental plan.
Each plan has its own network of dentists, and you’ll want to pick a network containing a dentist that you want to use. In general, the bigger the network the more choice you have, but in return for that freedom, your costs for care — your out-of-pocket costs — will be more.
With more than 3,400 dentists, UDP has Washington’s largest network, plus you get coverage when you travel outside the state. You’re allowed to use non-network dentists, though you’ll pay slightly more (10% more generally).
With the DeltaCare and Willamette plans, you’re required to select a primary care dentist from their network when you enroll. This dentist manages all your dental care needs, which includes referring you to a specialist when necessary. While you always have the option to change your primary care dentist, you must receive all care from within the plan’s network. Otherwise, you’ll pay the full cost for care.
Though DeltaCare and Willamette each have a smaller network than UDP, all three plans feature an array of dentists. Visit the websites listed below to browse each plan’s network. Call the plan directly if you want to find out whether a specific dentist is in the plan’s network.
|Plan||Plan group||Network||Find a dentist online|
Delta Dental of WA)
|Group 3100||DeltaCare||DeltaCare plan search|
|Willamette Dental Group||n/a||Willamette||Willamette Dental locations|
Delta Dental of WA)
|Group 3000||Delta Dental PPO||Delta Dental PPO plan search|
Cost and coverage overview
For all plans, you don’t pay any monthly dental insurance premiums — those cost are automatically included in your benefits package. You also pay nothing for preventative care, such as cleanings and x-rays, when you use dentists within your plan’s network. You do pay, though, for specific services, like fillings, root canals, braces, dentures, and the like. How you pay for these depends on which plan you choose.
With UDP, you first have to pay the yearly deductible before the plan starts paying for services. Then, you pay your share of the cost using coinsurance, which is a percentage of the total cost. If you need a filling, for example, you pay 20 percent of the cost (or 30 percent if you don’t use a network dentist).
A drawback to paying with coinsurance is that you may not know the full cost up front — you only know what percentage you pay. The other two plans, DeltaCare and Willamette, have more predictable costs because you pay for services using copayments. These are set costs. If you need a filling, you pay $10 to $50, depending on the exact procedure.
Additionally, neither DeltaCare nor Willamette has a yearly plan maximum. UDP has a yearly maximum of $1,750; you pay for all services once you reach that limit.
Use the information and links in the table below to review and compare the costs associated with each plan. The Certificate of Coverage describes the plan in detail. Read it only if you need to know something specific.
|Plan||Deductible||Yearly plan maximum||Costs for services||Certificate of Coverage (2017)|
|DeltaCare (administered by Delta Dental of WA)||None||No general plan max||DeltaCare coverage||DeltaCare COC|
|Willamette Dental Group||None||No general plan max||Willamette Dental Coverage||Willamette Dental COC|
(administered by Delta Dental of WA)
|$50/person $150/family||You pay amounts over $1,750||UDP coverage||Uniform Dental Plan COC|