Annual Benefit Enrollment
Starts October 7th.

Dental and Vision

Overview

There are several changes coming to your vision and dental benefits for 2014.

Summary of Changes
Plan Summary of Coverage Coverage Changes for 2014 Premium Changes for 2014 Open Enrollment
EPIC Benefits+ Supplemental dental coverage, vision discount plan (vision insurance for additional premium), hospital/surgical benefits, accidental death & dismemberment coverage Increasing per person benefit maximum from $1,000 to $1,500 for 2014 No change from 2013 premium Yes – limited annual dental maximum for most new enrollees
VSP Vision Insurance Partial coverage for a vision exam plus eyeglass lenses every calendar year and eyeglass frames once every other year or contact lenses every year; discount on laser vision correction Annual in-network contact lens allowance increasing, addition of KidsCare Program Yes – premium increase for 2014 Yes
Dental Wisconsin Stand-alone dental insurance plan that offers comprehensive dental coverage No No change from 2013 premium No
State Group Health Insurance – Vision Benefits* All health plans, except the Standard Plan, offer coverage for an annual eye exam No change for 2014 State Group Health Insurance premium increasing Yes – for State Group Health Insurance
State Group Health Insurance – Dental Benefits* All health plans, except the Standard Plan and SMP, offer dental coverage. Uniform Dental Benefit - health plans previously offered different levels of dental coverage State Group Health Insurance premium increasing Yes – for State Group Health Insurance

*If you have State Group Health Insurance, your health plan (exceptions noted above) provides coverage for an annual vision exam and Uniform Dental Benefits. This may meet your needs; however, additional coverage is available through our optional plans.

EPIC+ Benefits

EPIC Benefits+ provides supplemental dental coverage, a vision discount plan with the option to purchase vision insurance, an accidental death and dismemberment benefit and a hospital/surgical benefit.

  • EPIC Benefits+ is offering a special enrollment opportunity - you may enroll, add/remove vision coverage or add/remove eligible dependents
  • The annual benefit maximum is increasing for current members
  • Premiums are not changing for 2014
  • You may remove dependents or cancel coverage for 2014

NOTE: If you are enrolled in, or are considering enrolling in EPIC Benefits+ for 2014, you may wonder how Uniform Dental Benefits will affect this coverage(s).  Please see the comparison chart.

Benefit Changes for 2014

The annual benefit maximum will increase from $1,000 to $1,500 for covered dental services received on or after January 1, 2014 (does not apply to those enrolling during the special enrollment period who are subject to the graduated dental benefits in 2014 and 2015).

You may add the Vision Benefit Extension (which provides you with vision insurance through Davis Vision), during the special enrollment period if you have not previously been enrolled in this additional coverage.

Special Enrollment Opportunity

EPIC Benefits+ is offering a special enrollment opportunity.  If you decide to enroll in EPIC Benefits+ during the special enrollment period, your annual dental maximum will be limited in 2014 and 2015*. 

Annual Dental Maximums:
  • 2014 - $750
  • 2015 - $1,000
  • 2016 - $1,500 (full benefit)

*The limited annual dental maximums only apply to employees who enroll in EPIC Benefits+ during the ABE period. Dental benefits will not be limited in 2014 and 2015 for employees who were enrolled in Gundersen Lutheran, Health Tradition, Humana or WEA Trust health plans under the State Health Insurance plan in 2013.

At enrollment, you’ll have two options for vision benefits:

  • Affinity Discount Program – included at no extra cost.  This provides you with savings on vision care services and eyewear.  It is provides you with discounts; it is not a vision insurance plan.
  • Vision Benefit Extension – available for additional cost.  This provides you with vision insurance through Davis Vision.  You can see the provider of your choice, but your out-of-pocket costs are lower when you use a Davis Vision provider.

2014 Premiums

Premiums are not changing for 2014.

Monthly Premiums for 2014
Plan Employee Employee
+ Spouse/DP
Employee
+ Child
Family
EPIC Benefits+
without Vision Insurance
$19.77 $39.54 $39.54 $59.31
EPIC Benefits+
with Vision Insurance
$24.02 $47.04 $47.04 $70.34

Providers

You may see the dental provider of your choice but you will have lower out-of-pocket costs if you see a dental provider who is in the Delta Dental Premiere network.  For more information, visit the EPIC+ Benefits page.

VSP Vision Insurance

VSP provides partial coverage for contact lenses every year instead of eyeglasses or eyeglass lenses. It also offers discounts on laser vision correction. You may see the provider of your choice but your out-of-pocket costs will be lower if you use a VSP provider.

  • VSP Vision Insurance is offering an open enrollment opportunity - you may enroll or add/remove eligible dependents
  • You may remove dependents or cancel coverage for 2014

Benefit Changes for 2014

See the chart below to review changes to the VSP plan for 2014. Changes include the following:

  • In-network contact lens allowance increase
  • Premium increase for 2014
  • Addition of the KidsCare program - provides more coverage for children (details below)
VSP Benefit Changes for 2014
Benefit 2014 Coverage 2013 Coverage
Vision Exam $15 copay $10 copay
Evaluation and elective
fitting of contacts
Copay of $60 15% of fitting & evaluation
In-network allowance for contact lenses
(including evaluation and fitting)
$130 $105
Frames benefit from
non-VSP provider
$70 $45
KidsCare Program
  • Two exams per year
  • Impact resistant lenses
  • Lens replacement annually or as needed
  • Frames replaced annually with $25 copay
Not offered

2014 Premiums

VSP premiums are increasing for 2014.

2014 VSP Vision Premiums
Employee Employee + Spouse/DP Employee + Child Family
$6.35 $12.70 $14.30 $22.85

Providers

You may see the vision provider of your choice but you will have lower out-of-pocket costs if you see a VSP provider. For more information, see the VSP webpage.

Dental Wisconsin

Dental Wisconsin Insurance plan is a stand-alone dental insurance plan that offers comprehensive dental coverage.

  • Dental Wisconsin is not offering an open enrollment period for 2014
  • Premiums are not changing for 2014
  • You may not change from the PPO plan to the Select plan, or vice versa. If however, you are changing your health plan to the Standard Plan for 2014 and you are currently enrolled in the Select plan, you may submit a paper application to change to the PPO plan to obtain coverage for preventive and diagnostic care.
  • You may remove dependents or cancel coverage for 2014

NOTE: If you are enrolled in Dental Wisconsin PPO or Select plans, you may wonder how Uniform Dental Benefits will affect this coverage(s).  Please see the comparison chart.