Enrolling a spouse, dependent or family can only be done during the enrollment period of March 1 – 31. A spouse or family may only join for the entire year. If you don’t re-enroll each year you are electing to drop coverage for your one dependent/spouse or for the family. Your dependent/family must then wait 3 years to re-enter the dental plan. Eligible dependent children are covered up to their 19th birthday, up to age 25 if unmarried and a full-time student. Please provide legal documentation of a child’s eligibility.
There are 2 options to pay for your family dental coverage.
1. OPTION 1 – Full Payment: If you wish to purchase spouse or a single dependent coverage or family the MTABF must receive payment in full by March 31st. You may defer some or all of this cost by using the variable benefit for the following school year. To apply the variable benefit, this form must be accompanied by a claim form.
2. OPTION 2 – Biannual Payment: If you wish to purchase family coverage and would like to take advantage of biannual payments you must use the variable & make an additional payment for the remaining balance. The MTABF must receive the first half of the payment by March 31st & the second payment of by June 30th. To apply the variable benefit, this form must be accompanied by a claim form.
You may elect to use your following school year variable benefit to defray the cost of your dental. If you elect to do this, a Variable Benefit Claim Form must be submitted w/ your dental enrollment. If you are planning on retiring, you are NOT eligible to do this.
All requests for dependent and family dental coverage must be submitted with payment to the MTA Benefit Fund (check payable to MTABF) by March 31st and mailed to:
MTA Benefit Fund
C/o Preferred Group Plans, Inc.
P.O. Box 15136
Albany, NY 12212-5136
(*Managerial Confidential* - In order to ensure that your dependents are properly covered, please provide your dependents information & send in the enrollment form, mark it as Managerial Confidential, to Preferred.)
See all information on your dental plan.
P.O. Box # 656
Baldwin Place, NY 10505
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