In a time when it seems everything seems to be increasing, the rates, for the 2012 - 2013 school year will be the same as they have been for the last several years. For those wishing to cover only a spouse or one child, the cost will be $500. For those needing to cover 2 or more dependents (full family dental coverage) the cost will be $1095.
Enrolling a spouse, dependent or family can only be done during the enrollment period of May 1 – 31, 2011. 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 ($500) or family ($1095) the MTABF must receive payment in full for the 2012-2013 year by May 31, 2012. You may defer some or all of this cost by using the variable benefit for the 2012-2013 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 two payments for the remaining balance of the $445. The MTABF must receive the first half of the payment, $222.50, by May 31, 2012 & the second payment of $222.50 by October 31, 2012. To apply the variable benefit, this form must be accompanied by a claim form.
You may elect to use your July 2012 - June 2013 $650.00 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.
All requests for dependent and family dental coverage must be submitted with payment to the MTA Benefit Fund (check payable to MTABF) by May 31st 2012 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 the Dental Page for forms & additional information