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Participants that are able to participate in the Self-Pay Voluntary Dental Plan are those that are ELIGIBLE FOR HEALTH BENEFITS, which includes all of Self-Pay participants, and dependents. You and your dependents can enroll for coverage once you first become eligible for health benefits or during the month of November of each year during the Plan's Annual Open Enrollment Period. For election during the Annual Open Enrollment Period, the coverage effective date will be the first day of the following year, January 1. Dependent coverage can also be added at any time (as long you as are still eligible for health benefits) based on any of the life events listed under the Special Enrollment Situations section of the Health Summary Plan Description (SPD). Once we have received your payment, you will be billed automatically by the Fund Office for the next quarter. If you elect not to pay, then you and/or your dependents WILL NOT be eligible to join the plan until the next time you become eligible for health benefits through covered employment. To receive more information, please contact the Fund Office at (212) 869-9380, or toll free (800) 344-5220. Under President Obama’s Health Care Reform Law, the Patient Protection and Affordable Care Act requires all plans that offer dependent coverage for children must make such coverage available to a participant’s adult child whether, married or unmarried, until the child reaches age 26, even if the adult child no longer lives with the parents, is not a dependent on a parent’s tax return or is no longer a student. However, the extended eligibility does not apply to the adult child’s spouse or children. The new law would ordinarily take effect on June 1, 2011, but the Trustees elected to make this coverage available as of October 1, 2010. Please note that under this rule, if the adult child has another offer of dental coverage other than the Equity-League coverage, dependent coverage for that child will not be available. This condition is subject to change in 2014 based on pending legislative review under the Health Care Reform Act. This new option pertains to both the CIGNA CORE PPO and HMO Dental Plans. Once the dependent reaches age 26, the coverage will end as of the month he/she turns age 26. For example, if a dependent turns 26 on March 1st of a given year, his/her coverage will only remain active through March 31 of that year. The following is a comparison of the two offered plans to choose from: CIGNA Dental PPO Overview -This is the plan under which dental benefits used to be provided, now offered on a self-pay basis. This Overview provides a refresher on how it works.
CIGNA Dental Care (DHMO) Overview - This option, which costs less than the Dental PPO, works like an HMO, in that you’re limited to using providers in the CIGNA Dental Care network exclusively.
As of January 2012 Self-Pay Dental Coverage Costs
Please note that if you are electing dental coverage as of the start of a new Benefit Period - January, April, June, October, and had elected dental coverage in the past, your premium history will be reviewed. If you had paid for dental coverage within 12 months, and stopped paying for the coverage at some point during that period, you will be required to pay the premiums that were due for the balance of the 12 month period before coverage for the new election start date is activated. For example, if you are electing coverage as of July 1, and stopped paying for dental coverage through September 30th of the prior year, you will be required to pay back the 9 months of premium from October 1st of the prior year through June 30 of the current year. Please note that you can continue to self-pay for dental coverage continuously even if you are no longer covered under the CIGNA or HMO Medical Plans. The Next Step If you are eligible for self-pay dental (covered for health benefits through employment) and want to enroll for coverage you must complete the CIGNA Dental Enrollment form listed below and send it, along with your check, made payable to the Equity-League Health Trust Fund, for your first quarterly payment. The enclosed form should be returned to the Equity-League Health Trust Fund (P.O. Box 11533 New York, NY 10286-1533). To locate a Primary dentist under the DHMO plan or find in-network dentists under the Dental Core PPO plan, please visit Cigna's website, www.cigna.com , and follow these steps:
Use this form to enroll in the Dental HMO or the Dental PPO. When enrolling a dependent under either dental plan, you MUST provide proof of dependent status – for example, a marriage certificate, birth certificate, certification of student status, proof of residence and/or proof of financial dependency. This information is to be provided along with your completed dental enrollment form. If you are electing the DHMO, please make sure you also include a first and second choice selection for the Primary Dentist on the enrollment form as well. You may change your dentist on the DHMO by calling member services at the following number 1 800-244-6224. Member services can tell you when the change will take effect. Note that in order to maintain your coverage at all times, you must pay your quarterly premiums on time. If you have any questions on either of the self-pay dental plans, please contact CIGNA Member Services at 1-800-244-6224 or call the Fund Office 212- 869-9380, or toll free 1-800-344-5220.
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©2001, 2002 Equity League Pension and Health Funds This site does not change or otherwise interpret the official Plan documents. To the extent that any of the information contained in this website is inconsistent with the official Plan documents (which, of course, includes the Trustees' rights to amend or modify the Plans at any time), the plan documents will govern in all cases. No official (other than the Trustees) has any authority to interpret the Plans, or other official Plan documents, or to make any promises to you about them. Terms of Use | Privacy Policy |