Delta Dental will become the third-party administrator (TPA) of the State of Texas Dental Choice preferred provider organization (PPO) plan, and DeltaCare USA, an affiliate of Delta Dental, will become the new dental health maintenance organization (DHMO) carrier on September 1, 2019. These dental plans will be available to Texas agency and higher education employees, retirees and their eligible dependents.
ERS chose Delta Dental to manage the PPO and to offer the DeltaCare DHMO based on their large provider network and estimated costs that were lower than those of other companies that bid on the contract. HumanaDental has been the TPA for the PPO and insurer for the DHMO since 2009.
The State of Texas Dental Choice PPO is a self-funded plan, meaning that ERS sets the plan design and pays for the plan’s share of eligible dental care expenses. The TPA manages the provider network and processes the claims. ERS uses TPAs for its benefits plans to help keep administrative costs low.
ERS and Delta Dental will provide more information about the transition to Delta Dental and DeltaCare USA between now and Summer Enrollment. They are looking to make the change as smooth as possible for members and their families. Employees will have the chance to make changes to their dental coverage during their Summer Enrollment phase.
Source: ERS Coordinators Update Express (April 2019)