New Administrator Announced for Dental Plans

The Employers Retirement System (ERS) of Texas, which administrates health and dental benefits for community and technical college educators, recently announced changes in the plan administrator for its dental plans, effective Sept 1.

Humana will be replaced by Delta Dental. When you read the announcement below, you will see that it’s somewhat complicated and the effect upon you will depend upon the plan you have chosen previously. The question that immediately arises in these situations is whether your dentist or specialist will be in the new network. ERS and Delta Dental have stated that more information will be distributed during summer enrollment.

Here is the Delta Dental website, but it may be premature to learn whether the new network includes your doctor. With previous such changes, it has taken a while for the list of providers to be published. One strategy used by patients is to ask whether your particular dentist or specialist accepts the new insurance plan before making your next appointment.

Below is the official announcement from ERS:

Delta Dental will become the third-party administrator (TPA) of the State of Texas Dental Choice PlanSM preferred provider organization (PPO). DeltaCare USA, an affiliate of Delta Dental, will become the new dental health maintenance organization (DHMO) carrier on September 1, 2019. These dental plans are available to Texas agency and higher education employees, retirees and their eligible dependents. 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 chose Delta Dental to manage the PPO and to offer the DeltaCare DHMO based on their large provider networks and estimated costs that were lower than those of other companies that bid on the co

ERS and Delta Dental will have much more information during Summer Enrollment. Our goal is to make the change as smooth as possible for members and their families. Retirees not enrolled in Medicare—and their dependents—will have the chance to make changes to their dental coverage during their Summer Enrollment phase.