More Details Concerning Change in Dental Plan from ASO/SIDS to Empire BCBS

July 13, 2023

As previously reported, effective August 1, 2023, the NYCDCC Welfare Fund’s (the “Fund”) dental plan will be changing from the Administrative Services Only, Inc./Self-Insured Dental Services (“ASO/SIDS”) to Empire BlueCross BlueShield XPO (In-Network) and Dental Complete (In-Network) (“Empire BCBS”). As a follow up to the initial announcement, we have compiled some information to help you understand the new dental plan. In the coming days ahead, you will also receive a package in the mail that contains a new ID card from Empire BCBS (for dental coverage ONLY), as well as coverage details concerning the new plan. The envelope will be non-descript, so make sure you review your mail closely before discarding. 

Some highlights of the new dental plan through Empire BCBS include:

• A wider network of dental providers, including more abundant options for local providers, as well as those beyond the tri-state area. There are three types of networks: XPO (In-Network), Dental Complete (In-Network), and Out-of-Network. The network coverage breakdown is as follows:
  • XPO (In-Network)– Empire BCBS pays 100% coverage (after deductible, if applicable).
  • Dental Complete (In-Network)- Empire BCBS pays 80% coverage (after deductible, if applicable) [or 50% for Oral Surgery, Major Services, Prosthodontics, and Orthodontic Services].
  • Out-of-Network- Provides reimbursement per predetermined fee schedule.
• Active participants/dependents are entitled to:
  • An Annual Benefit Maximum of $2,500.
  • An Orthodontic Lifetime Benefit Maximum of $2,510.
  • An Annual Deductible of $100 (per member)
  • A Deductible Waiver for Diagnostic/Preventive Services (certain services such as Oral Evaluations and Teeth Cleaning, are limited to two per calendar year).
• Retired participants/dependents are entitled to:
  • An Annual Benefit Maximum of $1,500.
  • An Orthodontic Lifetime Benefit Maximum of $2,510.
  • An Annual Deductible of $100 (per member)
  • A Deductible Waiver for Diagnostic/Preventive Services (certain services such as Oral Evaluations and Teeth Cleaning, are limited to two per calendar year).
• A fast-acting, reliable, and helpful Customer/Member Services Department that is equipped to handle significant call volume.
• An ability to transfer/continue coverage if treatment began with previous plan (ASO/SIDS).
• An option for telehealth visits with dental providers.
• Emergency dental treatment for international travelers.
• Mobile and online tools to help make the most of your dental plan.

You can find more detailed information by clicking the images to the “Summary of Benefits” and the “Dental Provider Search” below. You will also be able to manage your dental benefit at www.empireblue.com.

Additionally, as we transition the dental plan from ASO/SIDS to Empire BCBS, we encourage you to ask your current dental provider if they are in Empire BCBS’s XPO or Dental Complete network. If they are not and you would like to recruit them to join the network, you can do so by having the provider’s office fill out this FORM and email it to providernomination@anthem.com.

If you have any questions concerning the new dental plan, please feel free to contact our Member Services Department at (800) 529-FUND (3863).