Because of action by the Local 237 Welfare Fund Board of Trustees, members should see money-saving improvements in the Welfare Benefits Plan that became effective Sept. 1. The savings will be realized from Board-approved increases in the fee schedule paid to participating dentists in the new 1200 Dental Plan.

The new fee schedule should reduce the need for participating dentists to request additional payment for covered services from our members. Also, members who do not use participating dentists will receive a larger reimbursement under the new 1200 Plan.

“Local 237’s Welfare Fund Benefits are undoubtedly among the best available,” President Carl Haynes noted. “While the cost of providing certain health and welfare benefits continues to rise every year, the union’s goal is to find ways, whenever possible, to save members money in the way of out-of-pocket costs while giving them greater options when selecting from a list of participating plan providers. The increases approved by the Board accomplish both goals.”

Haynes said the dental fee changes were made possible by a $200 increase in Welfare Fund contributions won from the city in negotiations last year. The estimated cost of this new program would be $700,000 a year.

Paul E. Juergensen, director of the Local 237 Welfare Fund, said the Board of Trustees determined that some of the fees paid in the previous plan were too low. Under the Board’s action, some of the fees paid to participating dentists were increased by more than 50 percent.

Fees Apply to New Work
The new fee schedule applies only to dental work rendered after Sept. 1. Treatments provided before that date will be processed at the previous Plan 1125 fee schedule, Juergensen said.

The Welfare Fund director pointed out that it is very important for members to obtain dental claim forms from the welfare office before any treatment is begun, unless it is an emergency. The claim forms, which are valid for only 30 days, may be obtained by calling the fund office at 212-924-7220.

If the work is not completed in 30 days, the member must request another dental form.

“You also must have an enrollment card on file at the office,” Juergensen said. “If you don’t, you can request that one be sent to you. That card must then be filled out and returned before any claim form can be issued.”

He noted that if there have been any changes in the member’s address or family status since their last claim, the fund office must be informed so a new enrollment card can be completed.

Although the Welfare Fund makes every effort to keep the list of participating dentists up-to-date, dentists join or withdraw on a continuous basis.

“It is the member’s responsibility to determine whether the dentist is participating in the plan before each treatment,” Juergensen emphasized.

The course of treatment under the new plan has been extended to 180 days, as opposed to 90 under the old plan. If the work takes longer, the member must submit a completed form for the work in progress at the end of the initial 180-day period.

Juergensen cautioned plan members not to pay any additional money or sign any agreements or payment plans with participating dentists until they verify that the charges are for services not listed in the current fee schedule. He also urged members to report any suspicion of dental fraud to the fund office.

Letters advising members of the new dental plan were sent out at the end of last month.