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What are the differences between the Dental Fee-For-Service, HMO and PPO Programs?
The fee-for-service plan allows you to go to any dentist of your choice. You or your dentist must then submit a claim form to Blue Cross for reimbursement. The Plan will pay according to its established fee schedule. The difference between the amount the provider bills and the amount the Plan pays is your responsibility.
For a Dental Plan claim form click here. Note: It is very important that you complete the correct form for the Plan you are in, as failure to do so will delay the processing of your claim and reimbursement, if applicable.
The Blue Cross Dental Managed Network Program, which is an HMO, requires you to enroll in the program and remain enrolled for a minimum of one year. Once you are enrolled, you may choose your dentist from a panel of participating dentists and then must use only that dentist for you and your family, if applicable. Covered services will be paid in full, and you will not have any out-of-pocket expense. If you use a dentist outside of the program, you will not be covered for those services.
To enroll in the Blue Cross Dental Managed Network Program, contact the Members’ Records Department at 718-591-2000, ext. 2491.
The DDS, Inc. program allows you to enroll at any time during the year by calling DDS, Inc. at 1-800-255-5681. The DDS, Inc. network is a closed panel of participating dentists who agree to accept the Plan’s allowances for covered services as payment in full. Once you have selected your DDS provider, you may make an appointment. No claim forms are required.
How do I file a dental claim?
Participants in the Empire Blue Cross and Blue Shield Fee-For-Service Program (the “Fee-for-service Program”): You and your dentist will need to complete a Dental Claim Form for all services received. You may obtain a Dental Claim Form by either clicking here or by contacting the Members’ Records Department. You complete the patient’s portion of the Dental Claim Form and your dentist completes the remainder of the form. Then return the completed form to Empire Blue Cross and Blue Shield Dental Benefits Program, P.O. Box 791, Minneapolis, MN 55440-0791.
Participants in the Empire Blue Cross and Blue Shield Dental Managed Network Program (the “Managed Network Program”): Once you enroll and select a dental office, you will not need to submit any forms or obtain pre-certification for any services. Your dental office will take care of any required paperwork.
Participants in the DDS, Inc. Program: You will not need to submit any forms or obtain pre-certification for any services. The DDS dental office is responsible for any required paperwork.
The Dental Benefit Plan of the Electrical Industry gives you three optional programs from which you and your eligible dependents can choose to receive coverage as listed below. Please note, participants in the Dental Benefit Plan of the Elevator Division should click here for information about their plan.
This information provides the highlights of the Dental Benefit Plan and is applicable to all three optional programs unless otherwise noted. Complete details are available in the Summary Plan Description (PDF, 518K).
Eligibility and Participation |
You are eligible after 26 weeks of work. Once under full employment, you must be working full time for a contributing employer for 26 consecutive weeks immediately prior to incurring a reimbursable expense. If you were unemployed during any or all of this period, you must be registered for employment in order to be eligible for Plan benefits. If you are unemployed and registered for employment, you remain eligible for coverage for up to 52 weeks. If you retire on an Early Standard, Standard, or Disability Pension from the Pension Plan (PHBP Trust Fund), you remain eligible for benefits under this Dental Plan. This benefit applies to your eligible dependents as well. |
Eligibility for Your Dependents |
You can cover your spouse and children. As a participant, you are able to cover your lawful spouse and children (adopted or biological). Stepchildren may be covered by purchasing COBRA. |
Covered Services |
Smile, we’ve got you covered. The Plan programs cover a wide range of services, including but not limited to basic and preventative care, prosthetics and orthodontic services. Refer to the Summary Plan Document (PDF, 518K) for a schedule of maximum allowances under the Empire BlueCross BlueShield Fee-For-Service Program. |
Pre-Certification |
No pre-certification is needed for Empire Managed Network or DDS options. Under the Empire Fee-For-Service Program, pre-certification of benefits is required for all prosthetic and orthodontic procedures before treatment begins, but not for basic preventative services. |
Plan Name |
Dental Benefit Fund of the Electrical Industry |
Plan Identification Number |
11-2585905 |
Plan Number |
507 |
| Plan Year |
July 1 through June 30 |
Type of Plan |
This is a multiemployer/employee welfare benefit plan providing dental benefits to covered employees and their eligible dependents. |
Plan Administrator |
Joint Industry Board of the Electrical Industry |
