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The SEBB Program's first annual open enrollment has begun and runs through November 15. Benefit coverage will begin January 1, 2020. Find out how to enroll. Note: ALEX, the online benefits advisor, is now available.
Compare dental plans
Compare the dental plans and benefits available to school employees and their dependents.
Note: You only pay the employee share of the monthly medical premium.
There are no school employee premiums for dental, vision, basic life and accidental death and dismemberment, and basic long-term disability insurance. These benefits are paid for by your employer.
On this page
Selecting a dental plan
If you are eligible for SEBB benefits, dental coverage is included for you and your eligible dependents. Your employer pays the premium. You and any enrolled dependents must be enrolled in the same dental plan.
How do dental benefits compare?
Before you enroll in one of our dental plans, use the tables below to get the details you need to help you decide. For information on specific benefits and exclusions, refer to the dental plan’s certificate of coverage or contact the plan directly. If anything in these charts conflicts with the plan’s Certificate of Coverage (COC), the COC takes precedence.
Annual costs
|
|
Uniform Dental Preferred Provider Plan |
DeltaCare Managed-care plan |
Willamette Dental Group Managed-care plan |
|---|---|---|---|
|
Deductible |
You pay $50 individual/up to $150 family |
None | None |
|
Plan maximum |
You pay amounts over $1,750 | No general plan maximum | No general plan maximum |
Benefits
|
|
SEBB Uniform Dental Preferred provider plan |
DeltaCare Managed-care plan |
Willamette Dental Group Managed-care plan |
|---|---|---|---|
|
|
You pay after deductible | You pay | You pay |
| Dentures |
50% PPO and out of state; |
$140 for complete upper or lower |
$140 for complete upper or lower |
|
Root canals |
20% PPO and out of state; 30% non-PPO |
$100 to $150 | $100 to $150 |
|
Nonsurgical TMJ |
30% of costs until plan has paid $500 for PPO, out of state, or non-PPO; |
30% of costs, then any amount after plan has paid $1,000 per year; |
Any amount over $1,000 per year and $5,000 in member’s lifetime |
|
Oral surgery |
20% PPO and out of state; |
$10 to $50 to extract erupted teeth |
$10 to $50 to extract erupted teeth |
|
Orthodontia |
50% of costs until plan has paid a maximum of $1,750 for member's lifetime (separate from the annual maximum of $1,750) |
Up to $1,500 copay per case |
Up to $1,500 copay per case |
|
Orthognathic surgery |
30% of costs until plan has paid $5,000 for PPO, out of state, or non-PPO; |
30% of the lesser of the maximum allowable or the fees actually charged; |
30%, then any amount over $5,000 in member's lifetime |
| Periodontic services (treatment of gum disease) |
20% PPO and out of state; 30% non-PPO | $15 to $100 | $15 to $100 |
| Preventive/diagnostic (deductible does not apply) |
$0 PPO; 10% out of state; 20% non-PPO | $0 | $0 |
| Restorative fillings | 20% PPO and out of state; 30% non-PPO | $10 to $50 | $10 to $50 |
| Restorative crowns | 50% PPO and out of state; 60% non-PPO | $100 to $175 | $100 to $175 |
How do DeltaCare and Willamette Dental Group plans work?
DeltaCare is administered by Delta Dental of Washington. Its network is DeltaCare SEBB (Group 9601).
Willamette Dental Group is underwritten by Willamette Dental of Washington, Inc. Its network is Willamette Dental Group, P.C. with dental offices in Washington, Oregon, and Idaho. Willamette Dental Group administers its own dental network (WA733).
DeltaCare and Willamette Dental Group are managed-care plans. You must select and receive care from a primary care dental provider in that plan’s network. If you choose one of these plans and seek services from a dentist not in the plan’s network, the plan will not pay your dental claims. Before enrolling, call the plan to make sure your dentist is in the plan’s network. Do not rely solely on information from your dentist’s office.
Neither plan has an annual deductible. You don’t need to track how much you have paid out of pocket before the plan begins covering benefits. You pay a set amount (copay) when you receive dental services. Neither plan has an annual maximum that they pay for covered benefits (some specific exceptions apply). Referrals are required from your primary care dental provider to see a specialist. You may change providers in your plan’s network at any time.
How does Uniform Dental Plan (UDP) work?
UDP is administered by Delta Dental of Washington. Its network is Delta Dental PPO (Group 9600).
UDP is a preferred-provider organization (PPO) plan. You can choose any dental provider, and change providers at any time. More than three out of four dentists in Washington State participate with this PPO.
When you see a network provider, your out-of-pocket expenses are generally lower than if you chose a provider who is not part of this network. Under UDP, you pay a percentage of the plan’s allowed amount (coinsurance) for dental services after you have met the annual deductible. UDP pays up to an annual maximum of $1,750 for covered benefits for each enrolled dependent, including preventive visits.
What providers can I see?
DeltaCare
You may only see providers in the DeltaCare (Group 9601) network. You'll have a primary care provider who oversees your care, and authorizes specialist referrals. If the provider you select is not in DeltaCare's Group 9601 network, you will be responsible for the costs.
Uniform Dental Plan
You may see any dental provider, but you'll usually pay less out-of-pocket if you go to a provider in the Delta Dental PPO (Group 9600) network.
Willamette Dental Group
You may only see providers in the Willamette Dental Group network. You'll have a primary care provider who oversees your care, and authorizes specialist referrals.
What if I see an out-of-network provider?
DeltaCare
You'll be responsible for the costs.
Uniform Dental Plan
You'll be responsible for having your provider complete and sign a claim form.
Willamette Dental Group
You'll be responsible for the costs.
Preauthorization criteria
Preauthorization is when you seek approval from your health plan for coverage of specific services, supplies, or drugs before receiving them. Some services or treatments (except emergencies) may require preauthorization before the plan pays for them. Preauthorization is not a guarantee, however, that your plan will pay for those services, supplies, or drugs.
Delta Dental of Washington (for DeltaCare and Uniform Dental Plan)
These criteria do not imply or guarantee approval. Please check with your plan to ensure coverage. Preauthorization requirements are only valid for the month published. They may have changed from previous months and may change in future months.
Contact
DeltaCare, administered by Delta Dental of Washington
Online: DeltaCare for school employees
Phone: 1-800-650-1583
Willamette Dental of Washington, Inc.
Online: Willamette Dental for school employees
Phone: 1-855-4DENTAL (433-6825)
Uniform Dental Plan (UDP), administered by Delta Dental of Washington
Online: Uniform Dental Plan for school employees
Phone: 1-800-537-3406
