PSC-CUNY Dental

November 2010

The PSC-CUNY Welfare Fund Dental Plan change period will be from Nov. 1, 2010 through Nov. 30, 2010. During this time, PSC-CUNY Welfare Fund participants and benefits-eligible employees can change their dental coverage provider.  Members can switch to DeltaCare USA DMO Plan by completing the Delta Enrollment form. Those who wish to switch to Guardian can complete the Delta Disenrollment form.

All welfare fund dental forms must be submitted to COHR by Tuesday, November 30, 2010.

Dental changes made during the Open Enrollment Period will become effective January 1, 2011.

Transfer-Out Form from DeltaCare USA DMO Plan to Guardian Dental Plan

To change your dental coverage from DeltaCare USA to Guardian, please click on the following link for the form.

PSC-CUNY Delta Dental Transfer-Out Form

Enrollment Form for DeltaCare USA DMO Plan

You must include the name and office ID number of your dentist on the enrollment application. You can get this information from the DeltaCare website at http://deltadentalins.com. The Find a Dentist box is at the lower right-hand corner of the page. The plan name is DeltaCare USA and group number is 5864-0001.

To change your dental coverage from Guardian to DeltaCare USA, please click on the following link.

PSC-CUNY Delta Dental Enrollment Form

Click on the following link for the PSC-CUNY Dental Open Enrollment Period.

PSC-CUNY 2011 Benefits Open Enrollment/Change Dates