As a benefits-eligible employee, the UW pays your dental plan premiums—a substantial benefit! It is your responsibility to enroll in a dental plan within 31 days of becoming benefits-eligible. You may change your plan choice annually during the autumn open enrollment period.
If you are enrolling in a dental plan, you can choose to enroll in a fee-for-service plan with a preferred provider network (i.e. Uniform Dental Plan) or one of two managed care dental plans (see choices below). To learn more about the differences, read on.
DeltaCare Dental - managed care plan, administered by Washington Dental Service
Willamette Dental - This managed care plan replaced Regence Washington Dental.
Uniform Dental Plan - preferred provider network
The main differences among the three plans are:
Managed care dental plans require that you use their facilities and/or dentists for all of your services. By doing this, they control their costs, and you pay less for services. Fees are usually a flat co-payment as listed in the plan book.
The Uniform Dental Plan is a fee-for-service plan with a preferred provider network option. You may use any dentist you wish. If you use a preferred-provider, your dentist will bill within the rate schedule, and you will only pay the employee share. You can find a preferred dentist from the Uniform Dental Preferred Provider list, which is managed by Washington Dental Service, the claims administrator for the plan.
If you choose a dental plan because you have been covered by that plan before with another employer, the coverage will not be the same. The contracts are specific to the employer.
Managed care dental plans either employ their own dentists or contract with certain dentists or clinics. Services can only be obtained from the plan's list of dentists. You must choose your dentist at the time you choose your dental plan. Be sure to call the dental office you want before choosing the plan, to ensure that they are accepting new patients. If you don't use a plan dentist, the plan does not have to pay your bills.
The Uniform Dental Plan is a fee-for-service plan which offers both preferred and non-preferred dentists. You may use any dentist you like anywhere in the world, however you will save money if you use a dentist from the preferred provider list.
Preferred providers on the state's approved list will submit bills for you. Your share of the bill will be limited to the preferred provider percentage stated in the plan book.
Non-preferred providers may bill the plan for you, but their reimbursement will be limited to the preferred rate schedule and you will pay the difference.
Managed Care dentists file any necessary claims for its patients.
Uniform Dental preferred providers also file claims for their patients, although if you use a non-preferred provider, they may or may not file claims for you. to file a claim yourself, download a claim form from the Uniform Dental Plan's website (listed above).
Eligible faculty and staff must select and enroll in a dental plan within 31 days from their initial eligibility date if they wish to choose their own plan, enroll dependents, and get prompt access to healthcare.
Use the Medical & Dental Enrollment/Change form and return it to the Benefits Office.
If you do not return an enrollment form to the Benefits Office, your dental enrollment will be "held" for about 90 days by the Health Care Authority (the agency in Olympia that administers the insurance contracts). No dental plan will receive enrollment information and no claims will be paid. After 90 days, if no enrollment form has been received, you will default to the Uniform Dental Plan employee coverage. Any pending claims will be considered under this plan. From that point until the next open enrollment period, you cannot change your plan, and you can only add a dependent if there is a qualifying change in your family circumstances.
Self-pay explains insurance options while you are on leave or laid-off.
COBRA addresses continuing your dental coverage after loss of eligibility.
Medical & Dental
Insurance Topics
Copyright © 2007 University of Washington
