Dental Plan Changes and Open Enrollment!

Effective 01/01/2025, PCTEA has changed our dental insurance administrator. Your dental benefits have not changed; we have simply replaced EmblemHealth with Guardian as the plan administrator.  Here are links to the Dental Coverage Details  and the Enrollment Application for dental coverage, which is also used as the application for changing your plan.

Some questions you may have about this change:

Why the Change?

Upon the expiration of our contract, EmblemHealth dramatically increased costs to renew with them at our previous level of coverage. PCTEA has changed our dental insurance administrator in order to improve service, and to help maintain the current costs of providing these important benefits to you at no cost. An additional benefit to this change is that Guardian has a significantly wider network, so you will have many additional options for choosing your dental provider and there is a very good likelihood that your current dentist will also accept Guardian.

In addition to this, we had the opportunity to expand coverage for those enrolled in our orthodontia plan.  The plan previously only covered orthodontic services for children but has been expanded to cover orthodontia for adults as well.  This covers 100% of the cost of orthodontic care up to a lifetime maximum of $2000 per person and is a separate benefit from any other dental services you may utilize, which has an annual maximum of $1500.  Please note:  This expansion to include adult orthodontia is included as an introductory offer and we strongly anticipate that the cost of this will be unsustainable into the future, so we do expect to remove adult orthodontic care from our plan options after two years.  You may switch your plan to enroll into the plan that includes orthodontia, but please only do so if you expect you or your dependents to receive orthodontia services within the next 12 months.  You’ll have another opportunity to enroll in this plan in November, during our regular open-enrollment period.

What Do I Need to Do?

Nothing  is required from you at this time and you will remain on your current plan if you take no action. You and your dependents have automatically been transferred over to Guardian. You should have received or will soon be receiving new dental plan ID card in the mail to be used for any dental services you receive after 12/31/2024.  These cards will come in an unmarked envelope with PCTEA as the return addressee.  Please do not throw these out.  The new plan has one dental card for the whole family, not separate ones per dependent. 

Since this change is occurring at the same time as the calendar year change, it should not affect annual maximums or deductibles.

In the month of January PCTEA is holding an open-enrollment to allow changes to be made to plans, Please note that the open enrollment period will end on 1/31/25, and all changes will take effect on 2/1/25.  Please note that deductibles and annual maximums will not reset upon changing plans, if you elect to do so. Click here for the application to make changes to your plan.

How do I find out if my dental provider is participating with Guardian Dental?

You can call your dentist and ask them if they participate with Guardian Dental or you can go directly to the website at guardiananytime.com to check.