Updated Dec. 10, 2024 — Anthem is now the dental insurance carrier for New York State employees. And while there have been kinks to work out since they officially took over for EmblemHealth on Oct. 1, many members responded positively to PEF’s recent solicitation for feedback.
“As with anything new, there are issues cropping up, but our Contract Administration Department is working hard to address each concern that is brought to their attention,” said President Spence. “We have received both positive and negative feedback and we are reviewing each one. If you have had a positive experience with a provider in your area, we urge you to email Communicator@pef.org so we can share it with other members.”
In your email, please be sure to include the name of the dental provider and your contact number or personal email so PEF can follow up as needed.
Several members have reported being able to return to their longtime family providers.
“So far, so good,” said Lauren B., in Region 8. “My family and I finally got back with my favorite dentist. My entire family celebrated when we found out we could go back to Potvin and Potvin (Hudson Falls, Washington County)!”
Another member said she had a good experience at Washingtonville Dental Group in Orange County, PEF Region 9.
“The coverage was great,” said Amanda T. “I need a crown and tooth pulled; they stated that both procedures are fully covered. I believe this is awesome and a great plan.”
Anne Y. also returned to a previous provider, Very Gentle Dental in Fayetteville, which is in PEF Region 4 (Onondaga County).
“Thank you so much for changing our insurance to Anthem,” she said. “My longtime dentist who stopped accepting our previous insurance plan due to low reimbursement rates now accepts Anthem, so I am able to return as a patient and I am so excited. Thank you for fighting for this change.”
Much of the negative feedback received by the union was about not receiving a physical ID card from Anthem; difficulty finding in-network care in rural parts of the state; discrepancies with the list of providers on the Anthem website, with some listed not actually accepting the plan; and reported delays in transfer of information from Emblem to Anthem.
With the goal of building and maintaining a robust network, New York’s contract with Anthem requires monetary penalties if Anthem fails to meet specified geographic standards for employee access to network dentists.
“While this does not guarantee every member access to network dentists it does far more to hold Anthem accountable,” said PEF Director of Contract Administration Debra Greenberg. “Of course, there are some areas in New York that simply have too few licensed dentists. PEF will be monitoring to make sure that the state holds Anthem to these contractual requirements.”
You can visit the Health Benefits section of the PEF website and scroll down to the Dental dropdown for more information, including a phone number dentists can call for details on joining the network. Members missing cards must call Anthem directly at (833) 821-1949 to obtain one. If you received a card with a missing number in the zip code, please call the number for a new one.
Many calls and emails are also coming in from PEF retirees about Anthem for active dental coverage or members who are newly retired and still on COBRA. The new provider has no impact on retirees who are off COBRA coverage and may have chosen Emblem Direct as their private carrier. Retirees on Emblem Direct Dental still have Emblem after the change.