Dental Plans
1-800-237-6060
PWCS offers two separate Dental Insurance plans through Delta Dental of Virginia.
All employees who work at least 17 1/2 hours per week are eligible to enroll in either dental plan. Employees do not need to participate in a medical insurance plan in order to participate in a PWCS dental insurance plan.
All new PWCS employees will have 30 days to enroll in benefits electronically coincident with their seated start date. Log in to the Employee Self Service to enroll in Medical Dental and Vision plans.
Enrollment for midyear changes for Medical, Dental Vision and Flexible Spending: Contact the Benefits and Compensation Department at benefits@pwcs.edu to request required forms.
Dental Plan Options
All full-time and part-time employees working 17 1/2 hours per week are eligible to enroll in the PWCS Delta Dental plans.
Employees may enroll in dental benefits without enrolling in medical benefits.
PWCS offers two plans: Delta Dental Standard Option or High Option. Enrollment is limited to one plan option only. The table below highlights the two options.
If you are looking for additional coverage to supplement your Delta Dental plan, please visit the Aflac website to learn about additional Dental coverage options.| Benefit | Standard Option | High Option |
|---|---|---|
| Diagnostic & Preventive (No Deductible) |
100% | 100% |
| Annual Deductible (Applies to Basic, Major & Ortho) |
$75* | $50* |
| Annual Benefit Maximum | $1,500*** | $2,000*** |
| Basic Dental Care | 70% | 80% |
| Major Dental Care | 50% | 50% |
| Implants | Not Covered | 50% |
| Orthodontics for Adults and Children | Not Covered | 50% |
| Orthodontics Maximum Benefit | Not Covered | $2,000 lifetime |
| Waiting Period | None | None |
*Deductible applies to up to three enrolled family members per calendar year
***Per enrolled individual per calendar year
For assistance in selecting the best Benefit plans for your family, visit Alex, our interactive online benefits counselor.
Both the Standard Plan and the High Plan cover services by both in-network and out-of-network providers. Select a dentist from the Premier Dental Network to receive the greatest level of savings on your out-of-pocket costs. Participating dentists have agreed to accept Delta Dental's payment and any patient coinsurance and/or deductible as payment in full for covered benefits. You may also receive care from an out-of-network dentist; however, that dentist may charge more than Delta Dental's plan allowance. You are responsible for any charges above the plan allowance, plus any required coinsurance and applicable deductible.
Predetermination of Benefits
Dentists may submit their treatment plan to Delta Dental for review and estimation of coverage before procedures are started. Delta Dental advises the patient and the dentist of what services are covered and what the payment would be. The actual payment for these predetermined services depends on eligibility, any plan limitations, coordination of benefits and the remaining maximum at the time services are performed. A predetermination plan is subject to change based on the dentist's participation status at the time of treatment and does not guarantee direct payment. Predetermination is optional, but it is strongly recommended for any dental services expected to exceed $250. Once the service is completed, the claim should be submitted to Delta Dental for prompt payment.
For more details information about our dental plans, please log in to the PWCS Intranet for plan summaries and comparisons.
Additional Delta Dental Information
The following guidelines apply for enrollment, changes, or policy cancellation for either the Delta Dental Standard Option or Delta Dental High Option dental plans:
- Employees may enroll within 30 days of seated hire date.
- Annual open enrollment - April to May (exact dates TBD) effective July 1 each year.
- Changes must be made within 30 days of an IRS Qualifying Event: family status change such as birth or adoption of a child, marriage, death of spouse, change in employment, or involuntary termination of spouse's/child(ren) health insurance coverage.
Eligible dependents for PWCS' benefits include:
- Your spouse; and
- Your biological children, stepchildren, adopted children (or children placed for adoption), and children for whom you have been appointed legal guardian or granted legal custody and who are under the age of 26 (special provisions apply for disabled children).
PWCS requires documentation demonstrating all insured dependents meet the eligibility criteria. Please visit the PWCS Benefits Intranet page to view the required documents. You have 30 calendar days from your hire/re-hire date (or date of status change or qualifying event) to submit your enrollment forms and applicable documentation before coverage becomes effective.