While PIPSC, alongside our union partners at the National Joint Council Dental Care Board of Management, is still negotiating hard to improve the majority of our members’ dental plan (NJC Component 55555), I am very pleased to announce that we have nailed down the following significant improvements, effective January 1, 2019. The major and minor changes to the plans starting next month are as follows:
The annual maximum coverage for routine and major services will increase 47%. The increase will be phased in from the current maximum of $1,700 per year to:
- $2,000 per year starting January 1, 2019;
- $2,250 per year starting January 1, 2020; and
- $2,500 per year starting January 1, 2021.
- Dental implants will be covered in their own right. (Currently, implants are partially covered by deeming them to be another procedure, i.e., a bridge or dentures. This has often led to gaps in, or problems with, coverage.)
- Coverage for replacement fillings for children will be possible 12 months after the initial filling is done (instead of 24 months).
- Congenitally missing teeth will be covered until age 21 (up from age 19).
- Coverage during suspensions is improved.
- An allowable break in service to become eligible for the plan is extended from 5 to 7 days.
- The new plan allows coverage for extra scaling to be approved retroactively. (Currently, this may only be approved in advance.)
- Charges for oral hygiene instructions will now be limited to once per lifetime per adult (and remain once per year for children).
- Coverage is eliminated for minor issues such as:
- The assistance of a second oral surgeon.
- Dental professional peer consultation.
- Trauma control if done at the same time as treatment for caries or pain control.
- Enlargement of the canal or pulp chamber as a part of dental treatment separate from doing a root canal.
For clarification on any of these plan changes please contact Dejan Toncic at firstname.lastname@example.org.