{"id":5300,"date":"2024-07-25T12:05:08","date_gmt":"2024-07-25T16:05:08","guid":{"rendered":"https:\/\/communicator.pef.org\/?p=5300"},"modified":"2024-07-25T13:52:21","modified_gmt":"2024-07-25T17:52:21","slug":"anthem-dental-plan-wont-diminish-benefits-more-information-to-come-before-oct-1-effective-date","status":"publish","type":"post","link":"https:\/\/communicator.pef.org\/issue\/volume-42-no-6\/anthem-dental-plan-wont-diminish-benefits-more-information-to-come-before-oct-1-effective-date\/","title":{"rendered":"Anthem dental plan won\u2019t diminish benefits; more information to come before Oct. 1 effective date"},"content":{"rendered":"

\"NYSAugust 7, 2024 —<\/em> Members made it clear \u2013 the EmblemHealth dental plan lacked a robust provider network, costing members too much in out-of-pocket expenses and making it difficult, or sometimes impossible, to find network dentists within a reasonable distance from their home.\u00a0<\/span>\u00a0<\/span><\/p>\n

PEF led a multi-year, multi-union campaign advocating for the state to change its dental insurer and as a result, the state put the NYSHIP dental contract out to bid for the first time in more than two decades, recently awarding the contract to Anthem Blue Cross (Anthem), effective Oct. 1, 2024. With Anthem\u2019s more robust network, many more members will be able to access network dentists.<\/span>\u00a0<\/span><\/p>\n

The process of making the switch can be confusing.<\/span>\u00a0<\/span><\/p>\n

\u201cWe want to dispel some misinformation at this point in the implementation process,\u201d said PEF President Wayne Spence. \u201cWe have heard concerns that with Anthem there will be a lower level of benefit or co-pays where none previously existed. This is absolutely not true. Anthem has many different dental plans. The new NYSHIP dental plan is a unique Anthem plan and details have not yet been published on the Anthem website.\u201d<\/span>\u00a0<\/span><\/p>\n

With the transition to a new provider, there have been questions regarding current \u201ctreatment in progress\u201d services, such as orthodontia. PEF has requested information from the state on the specifics related to such continuity of care and will pass on that information once it is received.\u00a0\u00a0<\/span>\u00a0<\/span><\/p>\n

The level of benefit is governed by the collective bargaining agreement, including enhancements achieved during the negotiation of the 2019-2023 PEF\/State Agreement, such as a higher annual maximum allowance of $3,000 per person, an increase to $3,000 for the orthodontic lifetime maximum per child, inclusion of a $600 implant allowance, and long overdue coverage for precious\/upgraded metal fillings.\u00a0<\/span>\u00a0<\/span><\/p>\n

\u201cThese previously negotiated enhanced contractual benefits will continue and will certainly not be diminished,\u201d said Spence. \u201cAs always, we will seek to build on these improvements in the next round of contract negotiations. Most importantly, with Anthem, our members will have access to a more robust dental network.\u201d<\/span>\u00a0<\/span><\/p>\n

The Department of Civil Service plans to send out the following mailings to NYSHIP dental plan enrollees:<\/span>\u00a0<\/span><\/p>\n