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Dental

Delta%20Dental

Foth has two plans to choose from, and pays a portion of the total premium. Covered preventive and diagnostic services are paid at 100% on either plan. Claims paid for such services do not reduce the annual maximum benefit. Additional preventive periodontal cleanings are available to those who have specific medical conditions (i.e., pregnancy, cancer, diabetes, high risk cardiac, and periodontal diseases). To receive these additional cleanings, enroll through the Delta Dental website.

Deluxe Dental – Summary of Benefits
Deluxe Dental – Summary Plan Description

Basic Dental – Summary of Benefits
Basic Dental – Summary Plan Description


Access your Account

Access your Delta Dental Account: deltadentalwi.com

  • Locate In-Network Providers: Searching for a dentist?  Consider a PPO dentist! PPO dentists have agreed to a lower contracted rate, thus saving you money.  If your current dentist is not a PPO dentist, encourage them to consider making the switch.  Choosing a dentist.
  • View Claims:  Access information about claims. Understanding your Explanation of Benefits (EOB)
  • ID Cards:  Print and/or request your ID card (If unable to log in, email Enrollment@deltadentalwi.com)
  • Access the Dental Claim Reimbursement Form: Used for dental expenses not applied towards the plan at the time of service
  • Enroll in Evidence-Based Integrated Care Plan (EBICP):  Allows up to 4 cleanings covered as preventive for certain conditions. Access additional information.

Dental Premiums (Per Paycheck)

  Deluxe   Basic
  Single   $11.56   $6.19
  Member +1   $27.79   $15.38
  Family   $33.00   $16.28

 


Forms

Affidavit of Domestic Partnership

Common Law Marriage Affidavit


Questions?

Delta Dental
Eligibility, claim issues, provider search
800-236-3713 or www.deltadentalwi.com

Benefits/Human Resources
For questions about enrollment, plan changes or general benefits inquiries, email Benefits@foth.com