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Frequently Asked Questions

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A list of the most commonly asked questions.

CIGNA rejected my claim for a tooth extraction. Why?

If your tooth was impacted, it is considered a medical condition and therefore, the charge must be submitted to your health insurance provider. You may submit any unpaid balance to CIGNA with a copy of the explanation of benefits from your health insurer. CIGNA will pay up to the scheduled amount. 

How often can I have crowns and dental prostheses replaced?

Crowns, bridges and dentures can be replaced after five years.

I was billed more than the standard $150 co-payment for a crown. Why?

The $150 co-payment is for a plain metal crown. If you and your dentist agree to use a precious metal crown, there will be additional cost to you.

How often can I get cleaning and routine dental exams?

Cleaning for adults is covered every three months. Exams are covered every six months (if using a participating dentist, there is a $15 co-payment). 

Will I have to wait for a reimbursement after I visit a dentist?

If you see a participating dentist and authorize the dentist to be paid directly by CIGNA, there will not be a reimbursement to you. If you use a non-participating dentist, your claim will be processed and a reimbursement will be sent to you.

How much will my dental care cost?

A Dental Schedule on the UFT Welfare Fund website displays the charges and reimbursements for most procedures. If you use a participating dentist, the procedures in black are free while those in red require a co-payment. If you choose a non-participating dentist, the amount you will be reimbursed is listed.

Where can I go for my dental procedures?

You have options on how to receive your dental care. If you are enrolled in the Scheduled Benefit dental plan, the best choice would be a UFT Welfare Fund participating dentist. However, you can choose any non-participating dentist. See more information about your dental coverage options through the Welfare Fund. 

How does a beneficiary file a death claim with the Welfare Fund?

A family member or beneficiary must submit a Welfare Fund Death Benefit Notification Form (available by calling the Fund’s Death Benefit Unit) along with a certified or original death certificate to the Welfare Fund. After verification of the information, the Fund will contact the beneficiary(ies) and process the claim payment.

What is Workers’ Compensation and who is eligible for Workers’ Comp benefits?

Workers’ Compensation is a form of insurance, paid for in advance by your employer, which entitles you to full medical coverage and part of your salary for job-related injuries and illnesses. You are entitled to Workers’ Compensation no matter whose fault your injury or illness may be with the exception of any acts willfully committed by claimant — so long as it occurred on school property or in the normal course of performance of your work duties. "Employer’s property" means the entire building, playground/s, authorized parking lots, sidewalk around the perimeter of the structure, and traveling between assignments including busing.

The following titles are eligible for Workers’ Comp: paraprofessionals, school nurses, occupational & physical therapists; substitutes; and any personnel who are not appointed to the Teachers’ Retirement System. Pedagogues injured or made sick on the job are covered by the Injury-in-the-Line-of-Duty provision of the UFT-DOE contract.

Whom at the UFT do I call if I have a specific question about Workers’ Comp?

Call the Workers’ Compensation Unit in the UFT Safety and Health Department at 212-510-6460.