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Comparing your Previous Dental Plan Administered by Aetna to your New Scheduled Dental Plan Administered by ASO/SIDS

Comparing your Previous Dental Plan Administered by Aetna to your New Scheduled Dental Plan Administered by ASO/SIDS

May 21, 2018

Effective January 1, 2018, the New York City District Council of Carpenters Welfare Fund (the “Fund”) changed your dental coverage on behalf of the Board of Trustees. The change involved a switch from your previous dental plan administered by Aetna DMO (“Aetna”) to a new scheduled dental plan administered by Administrative Services Only PPO (“ASO/SIDS”). This change primarily came as a result of your feedback. Among other concerns, some of you expressed that Aetna did not provide you broad enough access to dentists you wanted to use. Additionally, some of you also stated that you desired an option to use Out-of-Network dentists, which Aetna did not have. Both of these concerns were addressed by ASO/SIDS, which has a larger, higher quality dental network, and allows for Out-of-Network benefits.

Now that the change has been in effect for several months, we would like to offer some further clarification regarding how the new coverage through ASO/SIDS works, and the differences between Aetna and ASO/SIDS’ plans. To help you understand the differences between the plans, we have prepared the accompanying chart. In addition to reviewing the chart, you can also learn more about the current ASO/SIDS plan by reading an online version of the pamphlet describing the benefit on our website at www.nyccbf.com/wp-content/uploads/2017/11/DentalPlanBooklet_Web-Version_January-2018-FINAL.pdf or by visiting ASO/SIDS’ website at www.asonet.com.

Aetna

ASO/SIDS
Required to select a Primary Care Dentist (“PCD”) before receiving care. NOT required to select a PCD before receiving care.
A referral IS required before receiving treatment from a specialist. A referral is NOT required to receive treatment from a specialist.
There is NO Out-of Network coverage. There IS Out-of- Network coverage. Payment is based on the ASO/SIDS Fee Schedule. You can be balance-billed the difference.
NO Annual Deductible. Annual Deductible.

$100.00 per person- Excludes diagnostic, preventive, and orthodontic services.
NO Annual Maximum. Annual Maximum.

Active– $2,500.00 (per individual).

Retiree– $1,500.00 (per individual).
20% Patient Responsibility for Major Services. Once the $100.00 Deductible is met, 0% Patient Responsibility for Major Services.
Orthodontics– $1,200.00 fixed co-payment over 24-month period. 24 months of active treatment and 24 months passive treatment. Orthodontics– NO co-payment. NOT subject to Deductible. Maximum of 24 months of active treatment and 18 months of passive treatment.
Issued ID Cards referencing the participant’s PCD.

Do NOT issue ID Cards. Participants may log into ASO/SIDS’ website (www.asonet.com)  and print an ID Card.