Benefits: Benefit Trust Fund changes dental carriers

UUP has a new dental carrier. Effective June 1, the Benefit Trust Fund will be changing dental carriers from Delta Dental to CIGNA.

With CIGNA, UUPers will get a choice between the Preferred Provider Organization (PPO) and the Dental HMO (DHMO). Eligible members are automatically enrolled in the PPO plan. Eligible members who choose to switch to a DHMO plan must contact CIGNA to make the change.

What’s the difference between the CIGNA PPO and the CIGNA Dental Care DHMO?

The PPO plan is like the current Delta plan. It pays a percentage of the network allowance (80 percent, 60 percent or 50 percent depending on the type of service).

The DHMO can save you money: Many services are paid in full and there is no annual maximum. The DHMO plan, like a medical HMO, requires you to coordinate all of your dental care through your primary care dentists. But unlike a medical HMO, you can switch from the PPO to the DHMO or back again, each month. Also, with the DHMO, everyone in the family can choose his or her own primary care dentist.

Why CIGNA?

CIGNA has a great panel of dentists. The company offers members a choice, through the DHMO, which can save members money.

In addition, CIGNA has negotiated better discounts with participating providers. This also saves you money. For example, if Delta’s usual, customary and reasonable rate for a crown was $900, the member had to pay 50 percent, or $450. For the same procedure, CIGNA may have negotiated a rate of $800, so the member would pay 50 percent, or $400, when using a par provider. This also saves the Fund money, which could be used to maintain and, perhaps, enhance Fund benefits.

How do I find out if my dentist participates with CIGNA?

In the next week or so, you’ll be receiving an enrollment packet from CIGNA. It includes two participating provider booklets. The thick booklet — with nearly 7,000 participating providers — is for the PPO. The thinner booklet — with close to 2,000 dentists and more than 500 dental offices — is for the DHMO. You can also find a list of participating providers at www.cigna.com; click on the provider directory. When searching for dentists, you’ll need to specify PPO or DHMO.

What do I do if my dentist does not participate?

Talk to your dentists. Tell them about the change to CIGNA and ask them to call CIGNA at (800) 342-5234 if they’re interested in joining the network. You can also fill out a nomination form, available on the Web at www.uupinfo.org; click on benefit forms. CIGNA will contact the dentist once the nomination form is received.

What do I do if I want to stay with the PPO?

You don’t need to do anything. CIGNA will have you enrolled as of June 1. All claims incurred after that date should go to CIGNA.

What do I do if I want to change to the DHMO?

If you want the change to be effective June 1, you must call CIGNA and enroll by May 14. You’ll need to pick a primary care dentist for every member of the family. Call CIGNA at (800) 481-1213 to enroll.

With the DHMO, can I change my dentist in the future?

Absolutely. Any change you make by the 14th of the month takes effect the first of the following month.

You can change dentists by calling (800) 481-1213 or at www.cigna.com (in the provider search area).

What is www.mycigna.com?

This is the member’s personalized CIGNA Web site. You sign on (using your Social Security number and password) to access all of your dental information. You can see your claims as they process, as well as information on all of your dental claims. You can also use this site to change dentists if you’re in the DHMO.

What if I’m in the middle of a dental procedure?

If the date of service is prior to June 1, that claim would go to Delta. If the date of service is June 1 or later, the claim should be sent to CIGNA.

What about orthodontic care?

If you or a dependent has already started orthodontic care under Delta, any payment for care after June 1 would be made by CIGNA. To coordinate what Delta has previously paid, and what CIGNA will continue to pay, you can call a CIGNA Member Service representative at (800) 481-1213.

What if I have more questions?

Watch your mail for the CIGNA enrollment packet. It will contain a side-by-side comparison of the PPO and DHMO. It will also include participating provider lists.

You can also call a CIGNA representative at (800) 481-1213 or the UUP Benefit Trust Fund at (800) 887-3863.

NOTE: The UUP Retiree Dental Plans are not affected by this change.

— Gail Maloy, Director, Member Benefits and Service