Dental Care Plan Negotiations

After an extensive survey of all members covered by the PSAC Public Service Dental Plan, we are going to the table to negotiate improvements to our Dental Plan. We have tabled our initial proposals and will be back at the table in May. 

We expect for the Plan to be improved and updated to reflect your needs going forward. 

This is a separate negotiations process from the one that we are using for our collective agreement.  If we are unable to get to an agreement, we have access to binding arbitration. 

We have tabled the following improvements:

Improvements to Maximums and Reimbursement

Proposal

Current Provision

Basic services maximum to be separate from Major restorative. Basic services to have no set maximum and co-insurance at 100% paid

Co-insurance paid at 90%; covered up to $1,700

Increase co-insurance of major restorative and prosthodontic services such as bridges, inlays, onlays, crowns, periodontist services and dentures to 90% paid

Co-insurance paid at 50%

Create a separate maximum and increase the annual reimbursement per person for major restorative and major prosthodontic services to $3,000

Combined Maximum of $1,700 – preventative services count against the maximum

Increase the lifetime maximum per person for orthodontic services to a maximum of $5,000

Current maximum of $3,000

Change the dental fee guide to the current year

Fee guide lags by one year

Eliminate the annual deductible of $25 per single or $50 per family

 

 

Improvements in Coverage

Proposal

Current Provision

Allow the reimbursement of the cost for adults of dental cleaning and polishing and the application of fluoride every six months

Currently 9 months;

6 months is available to children

Increase the number of scaling units (to 12)

 

Coverage of 6 units which can be expanded to 12 under certain circumstances

Include coverage for implants

No coverage

Change the definition of eligible child to include children residing with the plan member part-time students, interns, or apprentices.

Only full-time students are covered

Full coverage without limitation for any accident suffered as a result of duties at work

 

 

Bite plates and mouth guard coverage to a set maximum of $500 every 3 years

No coverage beyond night guards for tooth grinding

Reduce the time period for replacements for crowns and bridges to 3 years

Replacements are not covered for 5 years

Crowns and veneers for any non-cosmetic reason

 

Can be excluded in certain circumstances

Allow re-imbursement of cost for a cavity that requires to repair before the 1-year period has expired in children

 

Ensure that fillings on crowned teeth are eligible

 

They are ineligible in some cases

One-time limit for teeth whitening of $500

 

 

Provide coverage for congenitally missing teeth at any age to correct congenital or developmental defects. 

This is only covered for people aged under 19

 

Other Issues

Proposal

Current Provision

Review authorizations by the member and who can sign for claims

 

Improve the ability to make claims electronically

 

Ensure the plan document is online

 

 

Topics: 

Employers: 

April 19, 2017
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