GBP dental plans get a new administrator

GBP dental plans get a new administrator

June 5, 2019
young woman is getting her teeth checkedOn September 1, 2019 Delta Dental will be the new third-party administrator (TPA) for the State of Texas Dental Choice PlanSM preferred provider organization (PPO) and will offer DeltaCare USA as the dental health maintenance organization (DHMO). These dental plans are available to Texas agency and higher education employees, retirees and their eligible dependents. HumanaDental will continue to manage the State of Texas Dental Choice Plan and the DHMO through August 31, 2019. 

Automatic Enrollment

If you are currently enrolled in either dental insurance plan you will not need to re-enroll, unless you want to make changes to your coverage; you can make those changes during your Summer Enrollment phase.

If you are not currently enrolled in a dental insurance plan, you can enroll during Summer Enrollment, with coverage beginning on September 1, 2019.

No ID cards

To help keep costs low, active employees and dependents will not get ID cards, and participating Delta Dental dentists should not require them.

If you do want a card, you can:

  • register for a Delta Dental online account to print an ID card,
  • call Delta Dental in September to request they print a copy of your online ID card and/or
  • use the Delta Dental app to download a virtual card to your smartphone. (Dependents will not have access to the Delta Dental app.)
Please note: only the employee’s or retiree’s name will be listed on the card. Dependents’ names will not be listed.

In August, ERS will mail a welcome letter to every employee and retiree enrolled in dental insurance. The letter will include the employee’s Delta Dental ID number. A dependent can get coverage at an in-network dentist by giving their own name, or the employee’s name and Delta Dental member number.

New dental website

The new dental website, which includes a provider search tool, is available now at www.ERSdentalplans.com. We will update the website at the end of June with more information and add a login feature in September. 

DeltaCare USA network

Keep in mind that if you enroll in the DeltaCare USA DHMO, you must use an in-network provider to get any benefits. You should make sure there’s an in-network dentist near you before enrolling in the DHMO. DeltaCare USA also requires that every participant designate an in-network primary care dentist (PCD).

If you are currently enrolled in the DHMO and your PCD is in the DeltaCare USA network, your PCD designation will transfer to Delta Dental.  If your dentist isn’t in the DeltaCare USA network,network , you can nominate them by clicking on “Recommend your dentist” and follow the prompts. Once Delta Dental receives your request, they will invite the dentist to join the network. It can take some time for a dentist to get processed into the network, and some dentists choose not to join at all. If you want to get care before the dentist you nominated joins the DHMO network, you’ll have to designate a PCD who is already in that network. You can change your PCD at any time. 

If you want to change your PCD or need to designate a PCD, you may do so by calling Delta Dental after you receive your welcome letter with your Delta Dental ID number in late August. You can have a different PCD than your covered dependents. 

State of Texas Dental Choice Plan networks

The State of Texas Dental Choice Plan has two networks: the PPO network and the Premier network. You will pay less if you see a dentist in the PPO network; you will pay a little more if you see one in the Premier network. (You will pay coinsurance in each network. The difference is that Delta Dental has negotiated lower rates for PPO network dentists, so you will pay coinsurance on the lower cost.) And, remember, in the State of Texas Dental Choice Plan, you can still see an out-of-network dentist. You will just pay a higher percentage of the costs.

If your dentist isn’t part of the State of Texas Dental Choice Plan networks, you can nominate him or her by clicking on “Recommend your dentist” and following the prompts. Once Delta Dental receives your request, they will invite the dentist to join the network.(You cannot nominate a dentist for a specific network within the State of Texas Dental Choice Plan. The provider and Delta Dental will work out which network the dentist will be in if they decide to join.)

Webinar for members

Register now for the Introduction to Delta Dental webinar on June 11 at 11 a.m. CT. During this webinar, you’ll learn about Delta Dental and how we will transition your dental benefits on September 1. If you can’t attend the live webinar, you’ll be able to watch a recording of the presentation on the ERS website by the end of June.

Delta Dental contacts

Beginning June 24, you’ll be able to call Delta Dental, toll-free, at (888) 818-7925 (TTY: 711), Monday – Friday from 8 a.m. to 7 p.m. CT. 

We will update the Delta Dental website in August with more information about next plan year’s benefits and the transition to Delta Dental. 

Continue to contact HumanaDental through August 31 if you have questions about your current dental insurance benefits.