PEF advocacy pays off as New York State inks deal for new dental carrier

ALBANY, NY (03/29/2024) (readMedia)-- It took years of hard work and tenacity on the part of PEF leaders and members, but New York State will replace EmblemHealth with Anthem Blue Cross as the dental provider in the NYSHIP plan, effective Sept. 1, 2024.

This is the culmination of years of effort. PEF led the way in pushing for a better dental plan for state workers, which will now benefit other bargaining units represented by Council 82, OMCE, NYSCOBA, and the State Police. All the unions agreed EmblemHealth was deficient and inadequate. Too few dentists accepted the plan, and the reimbursement rates for members who received out-of-network dental care were paltry.

"We saw all these dentists walking away from the Emblem network because they lose money and they can't afford to treat our members," said PEF President Wayne Spence. "When I became President in 2015, I started pushing changes to the plan."

The plan is particularly bad in parts of upstate New York where there are very few dentists who accept EmblemHealth, forcing members to pay high out-of-pocket costs. The union put out its own Request for Proposals (RFP) in 2020 and learned that there are other dental carriers with better networks and less expensive administrative fees than what EmblemHealth was charging the State.

"Emblem was really nothing but a coupon for our members," said PEF President Spence, "not nearly good enough to provide PEF members with the comprehensive dental care they deserve."

In PEF's current contract with the State, the union secured a $400-per-year annual stipend until the State replaced EmblemHealth as the dental carrier or significant improvements were made to the plan. The first year of that stipend – retroactive to 2023 – was paid in March 2024, costing the state more than $24 million (Approximately 51,000 PEF members times $400, plus administrative costs). PEF knew with dollar amounts like that the State would have a major incentive to fix the problem.

"We never backed down on this," said President Spence. "I've been hearing about how bad EmblemHealth is from members since I was first elected in 2015, and so I'm very glad that Anthem Blue Cross was selected to deliver high-quality dental benefits to public workers like PEF members employed by New York State."

Full details of the new dental plan will be released by the State during the 180-day implementation period. Coverage takes effect Sept. 1, 2024. PEF will schedule a telephone town hall for members to share more information as soon as it is received.