State-Sponsored Dental Plans
Delta Dental
DeltaCare USA
Premier Access
SafeGuard
Western Dental
State-Sponsored Vision Plans
Vision Service Plan (VSP)
*Vision benefits for BU6 employees are provided through the CCPOA Health Benefits Trust.
COBRA Carrier Contact Information for State-Sponsored Dental and Vision Plans
Please mail the Dental Plan Enrollment Authorization (STD. 692) forms to the corresponding dental carrier’s COBRA unit, and the Vision Plan Direct Payment Authorization (STD. 703) forms to VSP:
Delta Dental
Wolfpack Insurance Services, Inc.
P.O. Box 833
Belmont, CA 94002-0833
1-800-296-0192
DeltaCare USA
Wolfpack Insurance Services, Inc.
P.O. Box 833
Belmont, CA 94002-0833
1-800-296-0192
Premier Access
Attn: COBRA Unit
8890 Cal Center Drive
Sacramento, CA 95826
1-888-534-3466
SafeGuard Health Plans
Attn: COBRA Billing
P.O. Box 30910
Laguna Hills, CA 92654
1-800-880-1800
Western Dental
Attn: COBRA Unit
530 South Main Street, 6th Floor
Orange, CA 92868
1-866-859-7525
Vision Service Plan (VSP)
Attn: COBRA Unit
P.O. Box 997100
Sacramento, CA 95899-7100
1-800-852-7600 Ext. 4636