Dental Benefits
In an effort to provide Con Edison retirees and their dependents access to dental benefits, Metropolitan Life Insurance Company (MetLife) offers two retiree dental programs: Basic and Premium. Both plans cover preventative care at 100%.
The program pays a maximum of $1,000 per person each year under the Basic option and $1,500 per person under the Premium option for covered dental services. There is no coverage for orthodontia services.;
The best time to dig into the details of your dental insurance coverage is long before you file a claim. Spend a few minutes reviewing your different plan options and how they determine your coverage if you visit an in-network or out-of-network provider.
Read a guide to understanding your dental plan.
Below is the plan design for each of the available options. Note that the annual deductible applies to Type B and C services only:
| Basic | Premium |
||||||
| Coverage Type |
In-Network % of Negotiated Fee |
Out-of-Network % of MAC* |
In-Network % of Negotiated Fee |
Out-of-Network % of MAC* |
|||
| Deductible | $75 per individual | $50 per individual | |||||
|
Type A: Preventive (cleanings, exams, X-rays) |
100% | 100% | 100% | 100% | |||
|
Type B: Basic Restorative (fillings, extractions) |
50% | 50% | 80% | 80% | |||
|
Type C: Major Restorative (bridges, dentures) |
30% | 30% | 50% | 50% | |||
| Annual Maximum Benefit | |||||||
| Per Person | $1,000 |
$1,500 |
|||||
The program is entirely voluntary. If you decide to enroll, premium payments will be deducted from your monthly pension check. Whichever option you choose, you must remain in that option for at least two years before you can make another coverage change.
| Basic | Premium | ||||
| Monthly Payroll Deduction | |||||
| Retiree | $25.35 | $31.00 | |||
|
Retiree Plus One Dependent |
$55.76 |
$68.62 |
|||
|
Retiree Plus Family |
$69.94 |
$87.41 | |||
Visit MetLife to review details about their dental insurance programs.
Although Con Edison currently sponsors the Retiree Health Program, the information above does not alter the company’s right to change or terminate the program at any time due to changes in laws governing employee benefit plans, the requirements of the Internal Revenue Code, Employee Retirement Income Security Act, or for any other reason. The company is not obligated to contribute any fixed amount or percentage of program costs.
Notice of Privacy Practices
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that requires Con Edison and the health plans sponsored by the company to protect your personal health information (PHI). As a participant under one of the health plans offered by Con Edison, we are required to notify you of the privacy practices that will be followed by the company and the plans and your rights concerning your personal health information.
Under the law and privacy practices, we have the responsibility to protect the privacy of your personal health information by:
1. limiting who may see it
2. limiting how we may use or disclose it
3. explaining our legal duties and privacy practices
4. adhering to these privacy practices
5. informing you of your legal rights