Because you don't receive an ID card for your dental plan, you'll need to tell your dentist you're covered by the King County WDS dental plan (group number 00152). You must provide either your Social Security number or an alternative ID (if you've requested one) to your dentist for verification of your benefit eligibility. From there, your dentist (if a WDS/Delta Dental participating dentist) will handle all your claims and predetermination of benefits.

The "annual deductible" is the amount you must pay each year toward covered services before the dental plan begins paying. The dental plan deductible is $25 per covered person, up to $75 per family per year, for claims involving crowns, extractions, fillings, periodontics, root canals, onlays, dentures, fixed bridges, implants, occlusal (night) guards and temporomandibular joint disorder (TMJ) treatments. The deductible doesn't apply to diagnostic and preventive services, orthodontic services or treatment for accidental injuries.

After you've paid the deductible, if applicable, you begin paying a percentage—the coinsurance—of the cost of your dental care based on the incentive level you've earned and the type of service you're receiving. (For specific coinsurance rates, see "Your Dental Benefits at a Glance.")

The "benefit maximum" is the most the dental plan will pay for most covered services each calendar year. The dental plan's annual benefit maximum is $2,000 per covered person.

Two services have lifetime maximums, which don't apply to the calendar-year benefit maximum:

Your benefit maximum is calculated based on the services completed in a calendar year. Charges for dental procedures such as crowns and bridgework that require multiple treatment dates are considered incurred on the date the service is completed even if it began in the previous calendar year.

WDS increases the payment levels for your benefits through an incentive program. As long as you see your dentist for a covered service each year:

If you don't see a dentist for a covered service during the year, your payment level is reduced to the next lower payment level under which your last claim was paid, but never below 70%—for example, if you saw your dentist for a covered service in 2005 and your payment level was 80%, but you didn't see your dentist for a covered service in 2006, your payment level in 2007 would be reduced from 80% to 70%.

If you're a new employee, coverage begins at the 70% incentive level—levels "earned" under another group plan don't apply to the county's dental plan. However, incentive levels are adjusted based on previous participation in the county's dental plan if you're a:

The following table summarizes how the incentive program works.

The following examples help illustrate how the dental plan payment levels work.

Heather is in her second year of plan participation. She visits her participating dentist for her annual exam, which is a covered diagnostic and preventive service. Since she visited the dentist last year, her payment level for this year increased from 70% to 80%. The annual deductible doesn't apply to the preventive care Heather received.

Here's how much Heather pays:

Jim has been in the dental plan for three years, but he hasn't been to his dentist during any of those years—as a result, his payment level is 70%. This year, Jim needs a root canal. The annual deductible applies to this type of basic service and is met once Jim has the root canal.

Here's how much Jim pays: