Dental Benefits:

On Bellevue Payroll:
Dental benefits start immediately through CIR Housestaff Benefits Plan (no waiting period). The benefit year runs from July 1-June 30. You may select from two different Aetna dental plans: the Dental Maintenance Organization (DMO) or the Indemnity Dental Plan. If you do not select a dental plan at orientation, you will automatically be enrolled in the DMO (see below for details). You will then have one month to decide if you want to keep the DMO or switch to the Indemnity Plan. Beyond this period, changes may only be made on Jan 1 or July 1. Please note that dental claims must be submitted within one year of your visit.

There are two different types of coverage for dental services:

1) The Aetna US HealthCare Dental Maintenance Organization (DMO)

Key features (if you choose a participating dentist):

• There are over 600 participating dentists in the Tri-State area (but few in Manhattan). A list of providers can be obtained from the CIR Benefits Office at (212) 356-8180.
• No deductibles
• No charge for Basic “Part A” and “Specialty Part A and B” services (please see the CIR website below for specific service details)
• No annual or lifetime maximums
• Orthodontia is paid at 60% of the contracted schedule amount; there is no maximum orthodontic benefit

**If you are enrolled in the DMO plan and you use an out-of-network dentist, you will be reimbursed based on a schedule by Aetna. You pay for deductibles and charges over the scheduled amount.

2) The Aetna US Indemnity Dental Plan:

Key features:

• You see the dentist of your choice
• No deductibles
• You pay out-of-pocket and are reimbursed the scheduled amount by Aetna (some providers may be willing to be paid directly by Aetna). You will need to submit a Dental Benefits Request Form, which can be downloaded from the CIR website below.
• Annual limit of $2,000 for each person for each plan year (July 1-June 30)
• Lifetime maximum of $1,800 for orthodontia

For more detailed information about CIR HSBP Dental benefits, please see the website  http://cirseiu.com/benefits/nypublic/hsbp.cfm

CIR-Housestaff Benefits Plan
Address: 520 Eighth Avenue, Suite 1200, NY, NY 10010
Phone: (212) 356-8180
Fax: (212) 356-8181
Email: benefits@cirseiu.org
On NYU/HJD Payroll:
Eligibility for dental insurance begins upon employment (July 1st) for all housestaff. The BasicCare Benefits Enrollment Guide contains basic information regarding the differences among the choices. If you lose this Enrollment Guide, contact the NYU Benefits office below for a replacement. Briefly, the different plans are:

1. MetLife Dental PPO Basic and Plus Options: Participants in MetLife Dental PPO (basic or plus options) can receive dental care in- or out-of-network. Both Dental PPO options cover the same services, although at different levels. Your out-of-pocket costs are generally lower when you use an in-network dentist. If you go to an in-network dentist, he or she usually will submit the claim for you. If you see a dentist out-of-network, you will pay the full cost of the visit, and then can submit a claim for reimbursement.
PPO Basic key features:

• Higher annual deductibles that PPO Plus
• Annual maximum benefit of $1,500 per person
• For preventative care, this plan covers 100% in-network, and 80% out-of-network
• Only in-network orthodontia covered at 50% with a lifetime maximum of $1,500 per person

PPO Plus key features:

• Lower annual deductibles than PPO basic
• Annual maximum benefit of $3,000 per person
• For preventative care, this plan covers 100% both in- and out-of-network
• Plan pays 50% of both in- and out-of-network orthodontia, lifetime maximum of $2,000 per person
• Your annual premium for this coverage is higher than that for PPO basic

You can find a participating dentist at www.metlife.com/dental or by calling (800) 942-0854.

2. CIGNA DHMO: Participants in CIGNA DHMO (Dental Health Maintenance Organization Plan) must select a Primary Care Dentist from a provider list and receive care from in-network providers only. Out-of-network services are not covered under this plan. There are no annual maximums, no deductibles, and no claim forms. Most preventive services and restorative procedures are covered.

For more detailed information or to find an in-network provider, visit the CIGNA website at http://www.cigna.com/health/consumer/dental/care.html or call (800) 367-1037.

3. Decline Dental Coverage: Proof of other insurance is not required when declining dental coverage.

NYU Benefits Office:
One Park Avenue (between 32nd & 33rd Sts), 16th Fl.
Phone: (212) 404-3787 (Or Madelyn Ramos, Benefits specialist (212) 404-3773
Website: http://www.med.nyu.edu/hr/benefits
Hours: Monday – Friday, 8am – 5:30pm
Fax: (212) 404-3900
Email: NYUbenefits@nyumc.org

OnsiteHR office: (across from NYU Medical Center),Greenberg Hall, SC-2
Hours: Wednesdays, 8am – 4pm (Closed for lunch 11am – 12 noon)


Vision Benefits:

On Bellevue Payroll:
Vision benefits begin immediately through CIR Housestaff Benefits Plan (no waiting period). The maximum benefit is $100 per benefit per year ($100 each for you and your dependents). If you do not use your benefit, it is carried over to subsequent years up to a maximum of $300. This money can be used for eye exams, contact lenses, or prescription glasses/sunglasses.

You have two choices for coverage:
1. You may see an optometrist or ophthalmologist of your choice and pay out-of-pocket. You can then obtain an Optical Expense Claim Form from the CIR website http://cirseiu.com/benefits/nypublic/hsbp.cfm and submit it with your original receipt for up to $100 in reimbursement. The receipt must include your name, the service performed, and the total amount paid. If you purchase glasses, the word “prescription” must appear on the bill.

2. Alternatively, you may see a participating provider that may offer discounts for services, glasses, or contacts. You can call the Benefits Office at (212) 356-8180 and request an Optical Voucher and a list of participating providers. Once you pick a provider, you must bring the Voucher to your appointment. The Voucher will cover up to $100, so you only pay the amount above this out-of-pocket. The Voucher is good for 30 days. If the Voucher is not used, you may return it to the benefits office for a replacement.

For more detailed information about the CIR Vision benefit, please see the website http://cirseiu.com/benefits/nypublic/hsbp.cfm

CIR-HSBP
Address: 520 Eighth Avenue, Suite 1200, NY, NY 10010
Phone: (212) 356-8180
Fax: (212) 356-8181
Email: benefits@cirseiu.org

On NYU/HJD Payroll:
*There is no separate vision insurance for residents. Many ophthalmologists accept health insurance (United, Empire, etc.) for basic exams. You are responsible for the co-pay. You can call 1-888-7-NYU-MED (1-888-769-8633) to find an NYU ophthalmologist.