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Delta Dental and Maybe Switching?

The Fund Trustees have made new enhancements to the dental and hearing benefits offered to our eligible members effective July 1, 2018. The Guardian dental in-network benefit has been significantly improved for some of the most common expensive procedures: dental implants, oral surgery, crowns, and orthodontics.

Many of our members participate in the DeltaCare USA HMO (Delta) and not in the Guardian Dental network. The main difference in the two dental programs is that Delta is an HMO and has a much smaller network of providers compared to Guardian. Delta does not offer out-of-network coverage. Guardian is a Preferred Provider Organization (PPO) and has a large network of providers and offers out-of-network coverage. It is important to note that the recent Guardian upgrades are for in-network services only. Also, Delta does not cover implants.

Although the Guardian in-network reimbursement schedule has been enhanced for dental implants, oral surgery, crowns, and orthodontics, be aware that out-of-pocket costs for most procedures still may be lower in Delta than in Guardian.

If you are considering changing plans to take advantage of the new Guardian in-network reimbursement schedule and greater choice of providers, you should consider that you might end up paying more for your dental services than if you had continued with your Delta dentist.

If you would like to change to the Guardian plan, you have the opportunity during a special open enrollment period solely for Delta dental enrollees, beginning July 1, 2018, and ending August 31, 2018. Members who switch before July 31 will be retroactively enrolled in Guardian for July 1. Members who switch before August 31 will be enrolled for August 1.

A special change-of-enrollment form is here. Please return it to  PSC-CUNY Welfare Fund, 61 Broadway, 15th floor, New York, NY 10006, or fax it to 212-354-5363, and we will terminate your Delta enrollment and enroll you and your family in the Guardian dental plan. If you decide to make this change, please be sure to locate an in-network Guardian provider so that you will be able to take advantage of the in-network discounts. For more information on the Welfare Fund dental benefit, and a list of participating Guardian providers, click here.

A copy of this information was sent by letter to Delta participants.

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