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Retiree Dental

Click here for the Retiree Dental Booklet

 

As members of CSEA move towards retirement, rest assured that CSEA has provided the opportunity to continue benefits for dental into retirement.

 

If you are a State employee of the Administrative, Institutional, Operational or Department of Military and Naval Affairs bargaining unit, dental benefits do not continue into retirement; they must be purchased separately. Dental benefits do not become part of your health insurance.

 

If you are a member of the Unified Court System, dental and vision benefits continue into retirement.

 

If you are employed by a local government political subdivision such as a Town, Village, County, Public Authority or School District, please check with your employer to find out what benefits you carry into retirement.

 

In an effort to provide options, CSEA has created a Retiree Guide that can be obtained by contacting the CSEA Member Benefits Department at CSEA, Inc. by dialing 1-800-342-4146 ext. 91359# or ext. 91403#. The guide is a planning and reference tool for CSEA members and provides important information on pension, social security benefits at retirement as well as insurance plans endorsed by CSEA.

 

While reviewing the Retiree Guide, you will see many dental plans available for purchase. In an effort to assist the retiree in choosing the right plan for them, dental comparisons have been prepared showing the difference between all dental plans listed in the guide.

 

To view and/or print a copy of the comparison, you should know what dental plan you have as an active employee should you choose to opt for COBRA before choosing a retiree dental plan. Examples of EBF dental plans are State, Sunrise, Horizon, Equinox and Dutchess. Evaluating how you used your dental plan when you were an active employee may help you in deciding what, if any, dental plan will best fit your needs as a retiree.

 

 

The CSEA Employee Benefit Fund offers a Retiree Dental plan for retirees and their dependents. To access this dental plan, there must be a signed Memorandum of Agreement (MOA) in place between your employer and the CSEA Employee Benefit Fund. This agreement is an addendum to the Collective Bargaining Agreement and enables the Fund to contract directly with the Retiree. To find out if your employer has signed the MOA, please contact the Fund at 1-800-323-2732 ext. 803.

 

If a memorandum has been signed, you are eligible for the EBF Retiree Dental Plan if;

A retiree cannot obtain coverage for himself/herself or dependents if covered under another FUND dental plan. Dependents become eligible the same time you do. Dependents include spouse, unmarried children and legal wards under the age of 19. A child or ward who is incapable of self support by reason of mental or physical disability, provided he/she became so disabled prior to reaching the age of 19 are covered as long as the Retiree is eligible. Students under the age of 25 who are full time must be enrolled in a regionally accredited college or university and working towards a Bachelor's Degree, Master's Degree or Associate's Degree.

 

You may use any licensed dentist for dental care. A participating provider listing is available by visiting the Dental Provider area of this website. Printed provider lists are also available by calling 1 (800) 323-2732. There are over 2,200 participating dental offices in New York State that accept the fee schedule as payment in full for covered services. If you choose a non-participating dentist and are charged more than the amount listed under the schedule of allowances, you are responsible to pay the difference.

 

There is an annual maximum benefit of $1,800 per calendar year (January through December). Those who are about to undergo extensive dental treatment should discuss those plans with the dentist beforehand. Whenever the estimated cost of a recommended dental treatment exceeds $500.00, we advise the submission of the treatment plan before the work begins.

 

Payment Options

The Employee Benefit Fund offers 3 options for payment: The Direct Payment Plan, Credit Card Payment and Paper Bill.

  1. The Direct Payment Plan - Dental Plan premiums are deducted from your checkings or savings account.
  2. Credit Card Option - Dental Plan premiums are charged to your credit card. Current cards accepted: Visa, Mastercard and Discover.
  3. Paper Bill - mailed out the first week of every month.

The Direct Payment and Credit Card Options are voluntary and benefit you in many ways - they save time, and help you pay your dental premiums in a convenient and timely manner even when you're away on vacation or out of town. Both programs save postage and are easy to sign up for and easy to cancel. How do the programs work? You authorize regularly scheduled payments to be deducted from your checking or savings account or billed to your credit card. Your payments are automatically deducted or billed on the first of every month. The authorization you give to charge your account will remain in effect until you notify us in writing to terminate the authorization. If the amount of your payment changes, we will notify you at least 30 days before the next payment is due. The Direct Payment Plan and Credit Card Option are dependable, flexible and easy to use.

 

Using Your Coverage Outside of New York State

If you reside outside of New York State, please use the following guidelines for submitting dental claims to the Fund for reimbursement.

 

Dental

Dental Coverage does not require use of a participating dentist. When using a non-participating dentist, services will be reimbursed based upon your dental plan fee schedule. The dentist has the right to bill the difference between his/her charges and the fee schedule.

 

The Fund provides a list of providers outside of New York State who accept our dental plan fee schedule as payment in full for services covered in the plan. A printed list of participating providers is available by calling 1-800-323-2732 or by visiting our website at www.cseaebf.com. When searching for providers on our website, click on Provider Search tab on the homepage. Select Dental. Several search options are offered: By Location, By County or Alphabetically. After selecting the option, fill in the information and click Find Provider.

 

Helpful Information
- Only states with EBF providers are listed
- You may press Enter or Click Find Provider for all searches except State Search - For State, you must click Find Provider
- When navigating between tabs, the tab color will change to yellow
- The zip code search will provide dentists in and near your zip code area. Adjusting the miles will expand the provider list
- If browsing alphabetically, the list will include all providers throughout all counties and states on our provider panel
- Clicking on the Map and then the Red Marker will allow you to get directions to the provider office from your location.

 

Completed dental claims must be submitted on a universal ADA claim form. The claim should include the patients name, address, EBF ID#, date of service, service rendered, the ADA code for the procedure and the dentist's name, address and license number. Claims can be submitted electronically or mailed to the CSEA Employee Benefit Fund, P.O. Box 489, Latham, NY 12110-0489.

 

Should you have any questions regarding any of the above information, please contact the Fund toll free from throughout the United States at 1-800-323-2732 ext. 803.

 

To obtain a copy of your dental plan allowances, contact the Fund at 1-800-323-2732