Group Dental Plans

What It Is

The NYSUT Member Benefits Trust-endorsed Group Dental Plan is only available for purchase by local associations, their benefit funds, and employers. With the Group Dental Plan, your members have access to more than 5,000 dentists throughout New York state who are affiliated with Delta Dental, the largest dental benefits provider in the U.S. Delta offers insured and self-insured dental plans, as well as a DHMO (dental health maintenance organization) option in some areas. Delta can completely customize a new dental plan for your group, including your choice of deductibles, annual benefit maximums, orthodontia benefits and co-payments.

NYSUT Member Benefits Trust-endorsd Group Dental Plans are provided and adminsitered by Delta Dental.

Delta Dental Group Plans are NYSUT Member Benefits Trust (Member Benefits)-endorsed programs. Member Benefits has an expense reimbursement/endorsement arrangement of 2% of all premium paid to Delta by NYSUT member groups; 0.5% of all claims paid by those groups with an Administrative Services Only (ASO) dental program; or 2% of all premiums paid to Delta by NYSUT member groups with a Dental Health Maintenance Organization (DHMO) program. All such payments to Member Benefits are used solely to defray the costs of administering its various programs and, where appropriate, to enhance them. The Insurer pools the premiums of Member Benefits participants who are insured for the purposes of determining premium rates and accounting. Coverage outside of this plan may have rates and terms that are not the same as those obtainable through Member Benefits. The Insurer or Member Benefits may hold premium reserves that may be used to offset rate increases and/or fund such other expenses related to the plan as determined appropriate by Member Benefits. Member Benefits acts as your advocate; please contact Member Benefits at (800) 626-8101 if you experience a problem with any endorsed program.

Agency fee payers to NYSUT are eligible to participate in NYSUT Member Benefits Trust-endorsed programs.

Eligibility

The NYSUT Member Benefits Trust-endorsed Group Dental Plan is only available for purchase by local associations, their benefit funds, and employers.

All members of your group and their immediate families may be covered. The standard coverage for dependent children is to age 19, or to age 23 if full-time students. Your group may choose to be more or less restrictive in terms of dependent child coverage. Mentally and physically disabled dependent children are eligible regardless of age, as are physically incapacitated children incapable of self-support.

Features

• Participants can select any dentist, regardless of whether he or she is a member of Delta’s participating panel (not applicable to dental health maintenance organization option).
• More than 5,000 dentists participate within New York state alone. They guarantee pre-negotiated, limited fees and limit subscriber’s out-of-pocket expenses.
• Customer Service Representatives with at least 1 year of dental assistant schooling or chairside assisting are able to answer participants’ questions about dental office practice, dental procedures and plan specifics.
• Nationwide Customer Service is available toll-free, 8 a.m. to 8 p.m. weekdays.
• Claims in most cases are processed in less than 2 weeks.
• Included in your group plan quote is the cost of providing benefit brochures, claim forms, and monthly detailed group activity lists. These lists can be customized to your needs, and representatives are available to make presentations to Group Plan participants or to explain your plan and answer questions.
• Benefit Funds can customize a brief message on the Explanation of Benefits (EOB) to help remind participants that their dental benefits come from the union.
• Delta Dental has been committed to labor union service since 1955, when it became the first company to offer dental insurance for the Longshoremen’s and Warehousemen’s Union. Delta's office staff is organized by the Union of Needletrades, Industrial and Textile Employees (UNITE). The AFL-CIO recognizes Delta as a “union label company.”
• Groups often experience a reduction in claims cost ranging from 8% to 12% because of Delta's cost control measures. Delta’s not-for-profit status means premium dollars are used exclusively for dental benefits and operating costs, not for shareholder dividends.

Plan Options

• Your group may customize its plan by selecting various levels of coverage for all types of dental services, including diagnostic, preventive, basic restorative, oral surgery, endodontic, periodontic, major restorative, denture repair, temporomandibular joint dysfunction (TMJ), and orthodontic.
• Deductibles, co-pays and co-insurance amounts can be tailored to meet the needs of your group.
• Purchaser may select annual maximum benefit amount.
• Coverage for any benefits can be included or excluded for participants and/or dependents.

Obtain A Quote

To obtain a quote for a new group dental plan, you must provide the number of individual and family coverages in the group.

If you have an existing group dental plan, you should also provide a copy of the plan booklet describing benefit levels, current premiums and administrative fees and 1 or 2 years of prior dental claims experience. A copy of your last month's dental bill will capture census information, premiums and administrative fees.

For a quote on a customized plan or for more information on the dental options, including the dental health maintenance organization, contact Member Benefits toll-free at (800) 626-8101, weekdays from 9 a.m. to 5 p.m. Eastern Time.

NYSUT Member Benefits Trust-endorsed Group Dental Plans are provided and administered by Delta Dental.

Implement A Plan

Once the decision has been made to purchase the NYSUT Member Benefits Trust-endorsed Dental Plan on a group basis, here’s what needs to be done to implement this plan:

• Provide contact name/address/phone for billing, eligibility and contract.
• Sign and return contract.
• Provide eligibility information to Delta Dental - cards/printout/electronic transfer (Participant name, Social Security number, Date Of Birth, home address. If group is covering dependents, dependent name(s) & DOB also required).
• Benefits booklets mailed to contact person.
• General membership presentations/exhibits.
• Monthly billing.