PEF led a multi-year, multi-union campaign advocating for the State to change its dental insurer. Our main objective was finding a plan that provides you with a more robust provider network. We consistently heard that EmblemHealth’s deficient network cost way too much in out-of-pocket expenses when you had no choice but to go to an out-of-network dentist. As a result of this advocacy, the State put the NYSHIP dental contract out to bid for the first time in over two decades and recently awarded the contract to Anthem Blue Cross (Anthem), effective October 1, 2024. With Anthem’s more robust network, many more members will be able to access network dentists, which will help alleviate the out-of-pocket expenses caused by having to use out-of-network providers.
We want to dispel some misinformation at this point in the implementation process. We have heard concerns that with Anthem there will be a lower level of benefit or co-pays where none previously existed. This is absolutely not true. Anthem has many different dental plans. The new NYSHIP dental plan is a unique Anthem plan and details have not yet been published on the Anthem website. The level of benefit is governed by our collective bargaining agreement, including enhancements achieved during the negotiation of the 2019-2023 PEF/State Agreement, such as a higher annual maximum allowance of $3,000 per person, an increase to $3,000 for the orthodontic lifetime maximum per child, inclusion of a $600 implant allowance, and long overdue coverage for precious/upgraded metal fillings. All of these enhanced contractual benefits will continue and will certainly not be diminished. As always, we will seek to build on these improvements in the next round of contract negotiations. Most importantly, with Anthem, our members will have access to a more robust dental network.
The Department of Civil Service informs us they will be sending out the following mailings to NYSHIP dental plan enrollees:
NYS Dental Plan Administrator Change Letter
In July, the Department of Civil Service will mail this letter to enrollees’ homes. This letter will explain the change to Anthem and will highlight how enrollees can access and search the applicable Anthem Blue Cross network of dental providers.
Anthem Blue Cross NYS Dental Plan Benefit Documents and Benefit Card
In September, enrollees will receive a welcome letter from Anthem Blue Cross, which will include their new benefit card along with information on how to access benefit information and documents online through a secure member portal.
Please note that dental providers interested in joining the Anthem NYSHIP network can call 1-866-947-9398 to speak to a designated Anthem representative. Please feel free to share this number with your dental provider so they can join the applicable Anthem network if they are not already an Anthem participating provider.
We will provide more information as it becomes available. PEF will vigorously monitor the changeover to Anthem to make sure it meets all our expectations. If for some reason it does not, we will take immediate action to assure all necessary corrections are made.