The Fund Dental Plan offers services through a Participating Provider
Organization (PPO) and an Out-of-Network reimbursement benefit.
The
Dental PPO Program, consisting of over 5,000 providers, offers two
networks of participating dentists who have agreed to accept a specified amount
of payment directly from the Fund's Claims Administrator for each dental
procedure. MBF offers a lower deductible and higher reimbursement percentages
for services provided by In-Network providers. The PPO networks are offered
through Healthplex and MBF-SIDS Select PPO Programs, as well as the
CONNECTION Dental Provider Organization for members residing outside of New
York, New Jersey or Connecticut.
Under the Out-of-Network Option, a traditional fee-for-service reimbursement plan, eligible members are reimbursed after deductibles, at either 80%, 70% or 50% of Reasonable and Customary (R&C) allowances, depending on the services, once the member has paid the dentist and filed claim forms with the Fund's Claims Administrator, Healthplex.
Benefit Maximum. The maximum amount of benefits payable is $2,500 per person per benefit year, which runs from January 1st through December 31st. This applies regardless of whether the services are PPO or out-of-network, or both.
There is a separate $2,500 orthodontic lifetime maximum
that is not included in the $2,500 annual dental maximum.
For information regarding participating providers, please refer to the MBF PPO directories or call:
Healthplex
1-888-468-5179 (Dedicated Customer Service Line for MBF Members)
1-800-468-0600 (General Customer Service Line)
1-888-468-2183 (Provider Hotline)
Visit the Healthplex Web site
Note: Click "find a
dentist" on the left-hand side of the page.
CONNECTION Dental (for members residing outside of NY, NJ, or CT)
1-877-277-6872
Visit the CONNECTION Dental Provider
Organization Web site
MBF-SIDS Select PPO
Program
(718) 204-7172 ext. 5501
(516) 396-5501
(800) 537-1238 ext. 5501 (outside of New York City)
Visit the MBF-SIDS Select Web site
For questions pertaining to an Out-of-Network Dental
claim, please call the Claims Administrator, Healthplex.
Note: The Management Benefits Fund (MBF) does not recommend or endorse any particular dentist. Remember, you are responsible for selecting the dentist of your choice, participating or non-participating, and you should exercise the same care and apply the same criteria in selecting a participating dentist that you would in selecting a non-participating dentist.
Because many providers may practice at a site which is
listed as participating, you should verify the participation status of the
dentist who is actually providing treatment. Be sure to identify yourself
as an eligible member of the Management Benefits Fund and confirm that the
dentist is an MBF participating dentist.
See the Dental Benefits FAQ
Download this section of the
Fund Booklet (PDF) - Changes effective 12/01/08
Download the Healthplex Dental
Claim Form (PDF)
Read the Management
Benefits Voice Newsletter