Dental Insurance (Retiree)
This dental program is for retirees only.
Affordable dental care:
Dental insurance can help lower your out-of-pocket expenses so you and your family can maintain healthy smiles—and better overall health, too. Whether you are a new PEF Retiree or have been retired for a while, you can benefit from Sun Life’s Basic or Enhanced Plan. When you visit an in-network dentist, the plan pays some or all of your dental expenses for covered services after you satisfy your annual deductible—$25 for you, $50 for you and a dependent, or $75 for your family.
|Preventive & Basic Services (Type I and II)
Basic cleanings,* basic exam x-rays, fluoride treatments, oral examinations, amalgam fillings, root canals, extractions, and periodontal treatments*
|Major Services (Type III)
Dentures, crowns, and bridges
|Not covered under Basic Plan
Access to a national network of dentists:
Visit a dentist from United Concordia’s Alliance PPO network and you will have no out-of-pocket costs for covered preventive and basic services once you have satisfied the annual deductible. Finding an in-network dentist is easy—simply choose from more than 10,654 unique providers in New York and New Jersey, and more than 99,000 nationwide.1 If you choose to visit an out-of-network dentist, you will need to satisfy your annual deductible, pay the difference between Sun Life’s fee schedule and the dentist’s fee for covered services, and you may need to submit a claim form.
On-demand dental benefit information:
Visit us online for secure access to benefits and eligibility information, claim details, procedure history, maximum and deductible accumulations, printable ID cards and more.
Convenient pension deduction:
Pay your dental premiums through pension deduction and enjoy the freedom and time-saving convenience. Pension deduction also saves you check processing fees for dues (14% per year).
PEF Retiree members and their families are guaranteed eligibility for the New York State PEF Retiree Dental Program with no pre-approval or underwriting required. Here are a few things to consider once you are ready to sign up:
- You must be a PEF Retiree member at the time of your enrollment to be eligible for the PEF Retiree Dental Program.
- Coverage for dependent children will end on the last day of the month in which they turn 19 or age 25 if a full-time student.
- If you apply within 120 days of a Qualified Status Change (e.g., you get married), you can change coverage tiers (e.g., PEF Retiree Only or PEF Retiree plus dependents).
- If you terminate your dental coverage, you will not be allowed to re-enroll in coverage at a later date. However, if you previously terminated your coverage and have a Qualified Status Change (e.g., you get married), you may re-enroll in coverage if you do so within 120 days of the date of your Qualified Status Change.
Helpful information regarding the Enhanced plan:
- The Enhanced plan is available for an additional cost and does not cover orthodontia and implants.
- If you continued your dental plan under COBRA after your retirement and apply within 30 days of COBRA termination, you are eligible to select the Enhanced plan without a waiting period.
- If you apply for dental coverage within 90 days of having prior dental coverage, you are eligible to select the Enhanced plan without a waiting period provided that you submit proof of prior dental coverage with your enrollment form.
- If you apply for dental coverage 90 days or more after your prior dental coverage ends, you will be required to wait a year before you are eligible for the Enhanced plan. After the first year, you will have the opportunity to elect the Enhanced plan.
- Once you’ve enrolled in the Enhanced plan, you cannot modify your coverage.
- Download enrollment form and mail your enrollment form to PEF Membership Benefits Program, c/o Sun Life Financial, Member Adjustment Dept., W460, P.O. Box 725, Windsor, CT 06095-9950.
- Download enrollment form and fax it to Sun Life at (519) 342-6858 or (844) 295-7779,
- Email your enrollment form
- Call Sun Life at 1-844-738-8118, Monday through Friday, 8 am to 8 pm EST, to speak with a live Customer Service representative.
- Call Sun Life at 1-888-222-3660 or
- Visit them online to contact customer service via email.
To update your personal information:
- Call Sun Life at 1-844-738-8118
Monday through Friday, 8 am to 8 pm EST, to make updates to your personal information (i.e., name changes, address changes, incorrect date of birth or Social Security number). Mention group number 823699.
About Retiree Membership Dues:
Retirees should call:
1-518-785-1900, ext. 289
1-800-342-4306, ext. 289
For Billing, call PEF Membership Benefits at:
1-518-785-1900, ext. 243 or
1-800-342-4306, ext. 243
1. As of June 30, 2014, according to United Concordia records.
The network is made available through an agreement with United Concordia Companies, Inc. Claims administration services are provided by United Concordia Companies, Inc.
*Some restrictions apply.
**The Enhanced Plan does not cover Orthodontia and implants.
Sun Life dental insurance does not provide coverage for pediatric oral health services that satisfies the requirements for “minimum essential coverage” as defined by The Patient Protection and Affordable Care Act (“PPACA”).
In New York, group dental insurance policies are underwritten by Sun Life and Health Insurance Company (U.S.) (Windsor, CT) under Policy Form Series GP-A, and GC-A. Product offerings may not be available in all states and may vary depending on state laws and regulations.
© 2015 Sun Life Assurance Company of Canada, Wellesley Hills, MA 02481. All rights reserved. Sun Life Financial and the globe symbol are registered trademarks of Sun Life Assurance Company of Canada. Visit us at www.sunlife.com/us.
GDBCH-EE-4563x SLPC 26101 03/15 (exp. 01/18)