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Special coordination of benefits for the dental plan

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 is applicable to panel dentists. If you utilize the services of a panel dentist, you would generally have no out-of-pocket costs. You will not be charged co-payments that are listed on our dental schedule. The Fund will pay the dentist for the applicable co-payments. However, payments for upgraded or non-convered services will still be the responsibility of the member.

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/Florida PPO Panel

SCOB is applicable to panel dentists. If you utilize the services of a panel dentist, you would generally have no out-of-pocket costs. You will not be charged co-payments that are listed on our dental schedule. The Fund will pay the dentist for the applicable co-payments. However, payments for upgraded or non-covered services will still be the responsibility of the member.

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.
  4. Only one member or spouse/domestic partner is permitted to enroll in Dentcare.