RETIREMENT AWARENESS
PRE-RETIREMENT
DENTAL CHOICES
Dental Plans Available to PEF Retirees
A PEF member's dental coverage will end on the last day of the month after his or her last day on the payroll. Members who are retiring have three options for continuing dental coverage. Coverage may be continued: 1) under COBRA, a federal continuation of coverage law; 2) by converting to a direct-payment policy; or 3) by enrolling in the PEF Retirees’ Dental/Vision Program.
COBRA Continuation
Name of Plan - GHI Preferred Dental Plan
Enrollment Procedures - Members enrolled in the New York State Health Insurance Program (NYSHIP) will automatically receive information on continuing dental coverage under COBRA. Members who are not enrolled in NYSHIP must write to the NYS Department of Civil Service for a COBRA application. Continuation of coverage under COBRA must be requested no later than 60 days from the date coverage would otherwise end or within 60 days from the date of notification, which ever is later. **NOTE** Coverage under COBRA can only be continued for 18 months, with extensions permitted in certain situations for up to 36 months. After COBRA coverage ends, a retiree who wants to continue dental coverage must choose another option.
Effective Date of Coverage - Coverage begins on the first day of the month following retirement date.
Premium Contribution – The enrollee will have to pay 100% of the Premium for his
or her continuation coverage plus a 2% Administrative fee. As of 1/1/08
monthly rates are $29.29/individual (vision coverage would be an additional
$3.47) and $76.43/family (vision coverage would be an additional $9.25). Payment
is made to NYS Department of Civil Service.
Plan Description - The GHI Preferred Dental Plan includes a panel of participating dentists with 3,298 dentists. A
participating dentist has agreed to accept GHI's Preferred Dental Plan Schedule of Allowances as payment in full for covered services. Enrollees may also choose to use a non-participating dentist. If an enrollee uses a non-participating dentist, s/he will be reimbursed either 80% or 100% of the Preferred Dental Plan Schedule of Allowance depending on the service(s) performed. S/he will be responsible for any difference between the dentist's total charge and the payment made by GHI.
For Additional Information - If you need to request a COBRA application, write to the Department of Civil Service. Send name, Social Security number, address, telephone number with area code and reason for requesting the application to: COBRA Unit, Employee Benefits Division, State of New York Department of Civil Service, The State Campus, Albany, NY 12239.
Direct Payment Policy
Name of Plan - GHI Retiree Preferred Plan
Enrollment Procedures - Retirees automatically receive an enrollment form about 90 days after they retire. If an individual does not receive the form, s/he can call GHI at 1-800-947-0101 to request one. A retiree must enroll in this plan at the time of retirement. This is the only opportunity to enroll, unless coverage is continued through COBRA. When COBRA coverage ends information about enrolling in GHI Retiree Preferred Plan will be provided.
Effective Date of Coverage - Coverage begins on the first day of the month following retirement date.
Premium Contribution – The enrollee is billed by GHI on a quarterly basis.
As of 3/1/08 the rates are individual: $35.38 per month; individual + spouse
$66.60 per month; family: $98.74 per month.
Plan Description - The GHI Retiree Preferred Plan has a panel of 3,400 participating providers. Enrollees have the option of using a participating or non-participating dentist. Using a participating dentist will minimize or eliminate most out-of-pocket expenses. When using a non-participating dentist, the enrollee must pay the difference between the plan's allowance and the dentist's charge.
For Additional Information - Contact GHI at 1-800-947-0101.
PEF Retiree Dental/Vision Program
Name of Plan – PEF Retiree Dental Plan & EyeMed Vision Care (discount vision
plan)
Enrollment Procedures - This program offers continuous enrollment. A retiree may enroll in the dental and vision combination plan; OR the vision plan can be purchased as a separate policy at $21.85 a year.
Effective Date of Coverage - Coverage becomes effective on the first day of the following month after receipt of the initial premium, if the application and check are received by the fifteenth of the month. If they are received after the fifteenth, coverage will become effective on the first day of the subsequent month.
Premium Contribution - Three benefit levels are available. Three types of enrollment (Member, Member + Spouse, and Family) are also available. Premiums vary according to benefit level and enrollment selected, and include costs of dental and vision programs.
Plan Description - The GHI Preferred Plan has a panel of 3,400 participating providers. Enrollees have the option of using a participating or non-participating dentist. Using a participating dentist will minimize or eliminate most out-of-pocket expenses. When using a non-participating dentist, the enrollee must pay the difference between the plan's allowance and the dentist's charge.
The EyeMed Vision Care offers discounts on eye exams and eyeware.
Dental and Vision Plans Available to Retirees
For Additional Information - Contact the PEF Retirees Dept. at 518-785-1900 or 1-800-342-4306, ext. 289.
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