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Quality coverage for ERS members

If you’re considering dental coverage, you have access to one of two plans through ERS and Delta Dental, one of the largest dental plan providers in the country. Here's an overview of the benefits offered to you.

Coverage

You can enroll in either the State of Texas Dental Choice Plan^SM preferred provider organization (PPO) or the DeltaCare^® USA dental health maintenance organization (DHMO) plan. Both cover a range of services such as preventive cleanings and exams, fillings, extractions, crowns and non-cosmetic orthodontic services. They differ in their networks, premiums and out-of-pocket costs.

State of Texas Dental Choice Plan PPO

This plan allows you to visit any licensed dentist, with lower out-of-pocket costs if you see a dentist in the network.

The PPO plan pays 100% for in-network diagnostics and preventive care. For in-network treatment, it pays the following after you meet an individual $50 deductible or $150 family deductible:

• 90% for basic services such as fillings and
• 50% for major services (crowns, bridges, dentures).

DeltaCare USA DHMO

The DeltaCare USA DHMO requires you to use a DeltaCare network dentist, and to select a primary care dentist. The plan pays nothing if you see an out-of-network dentist.

With the DHMO plan, there’s no deductible. You’ll know upfront what your costs will be, and you’ll get two exams and two cleanings per year at no copay or coinsurance.

The DeltaCare USA DHMO has a smaller provider network and doesn’t cover any out-of-network services. Therefore, before signing up for this plan you should make sure there’s a  DeltaCare USA network provider in your area who is accepting new patients. You and your enrolled dependents can have different PCDs.

Cost

The monthly premiums for the two plan are very different because the provider networks and out-of-network coverage are so different.

The PPO plan costs more, but it allows you to see any provider you want. (You’ll spend less, though, when you see an in-network provider in Delta Dental’s PPO network.)

DeltaCare USA has lower premiums, but the network of dentists is smaller, there is no out-of-network coverage and you must visit your chosen PCD to coordinate your care.

Premiums won’t increase in Plan Year 2025.

How to enroll

You may enroll yourself and dependents:

• during Summer Enrollment,
• within 31 days of a qualifying life event (QLE) such as marriage or a new child or
• within 31 days of starting work at an agency or higher education institution that participates in the Group Benefits Program (GBP) or 60 days if you have a health coverage waiting period as a new employee.
• During your Summer Enrollment phase or after a QLE, you can enroll through your ERS OnLine account, by filling out a Summer Enrollment form and returning it to you HR department, or by calling ERS.

Learn more

To find out more information, visit the State of Texas Dental Choice/Delta Dental website. You can also call Delta Dental customer service at 1-888-818-7925.