SPECIAL COORDINATION OF DENTAL BENEFITS
Special Coordination of Dental Benefits
(For members and their spouse/domestic
partner who are also UFT Welfare Fund members.)
A. SCHEDULED BENEFIT PLAN
Members and their spouse or domestic partner who are
also members are entitled to Special Coordination of
Benefits (SCOB) when the Scheduled Benefit Plan covers
both.
SCOB can significantly increase reimbursement for dental work. If you utilize the services of a non-participating dentist whose charges are above the schedule of allowances, you will be eligible for additional reimbursement under your spouse’s/domestic partner’s coverage. You are covered for up to twice the fee schedule, not to exceed the dentist’s actual charges.
SCOB does not extend limitations on time or frequency of treatment. For example, one (1) exam every six (6) months does not become one (1) exam every three (3) months; but the reimbursement for the exam could be higher.
To obtain the special coordinated dental benefit, check the box on top of the form to indicate special coordination of coverage and submit it directly to CIGNA.
NOTE: Do not assign these benefits to your dentist. Assignment will interfere with the Welfare Fund’s ability to administer your coordinated benefits.
B. SIDS
SCOB is not applicable to SIDS panel dentists. If you utilize
the services of a SIDS panel dentist, you would generally
have no out-of-pocket costs except for the $50 or
$100 co-payment for certain procedures. This co-payment
would not be reimbursable through SCOB.
C. DENTCARE & SCHEDULED BENEFIT PLAN
1. You may also elect to have your family covered under
Dentcare and the Scheduled Benefit Plan. One member
enrolls in Dentcare and the other member stays in the
Scheduled Benefit Plan.
Under this option, you and your family members may use either a Dentcare dentist or a non-Dentcare dentist. Services rendered by the non-Dentcare dentist would be reimbursed according to the Scheduled Benefit Plan.
2. SCOB (additional reimbursement as explained in Part A above) would no longer be applicable.
3. Out-of-pocket costs incurred under the Scheduled Benefit Plan are not reimbursable through Dentcare.
D. FLORIDA DENTAL DISCOUNT PLAN & SCHEDULED
BEENFIT PLAN
You may elect to have your family covered under the UFT Florida Dental Discount
Plan and the Scheduled Benefit Plan. One member and dependent enroll in the
UFT Florida Dental Discount Plan and the other member does not.
Under this option, you and your family members may use your UFT Florida Dental Discount dentist and submit the “discounted fees” to CIGNA for reimbursement under your spouse's/domestic partner's coverage. If you did not use your UFT Florida dental discount dentist, however, you would have only your spouse's/domestic partner's coverage.
Only one member or spouse/domestic partner is permitted to enroll in the UFT Florida Dental Discount Plan.