The Benefits+ plan provides you with additional Dental, Hospital and Surgery, and Accidental Death and Dismemberment coverage, along with the option to purchase additional Vision coverage.
The Dental Wisconsin dental plans provide complete dental coverage or additional dental coverage to complement your state dental coverage.
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BENEFITS+ CONTINUATION FORM
DENTAL WISCONSIN CONTINUATION FORM
Hospital & Surgery Claims
Benefits+ members – your hospital and surgery claim must be filed by you, not your provider.
Please submit claims within 120 days of the service date. Find the Hospital Indemnity and Outpatient Surgery Claim Form to the right under Wisconsin State Contacts and fax your claim to EPIC Specialty Benefits at 800-236-7610.