Enhanced Dental, Vision and Hearing Aid Coverage Here is an example of how Piggyback works This is only an example of coverage. Example based on CCPOA Primary Dental benefits and assumes you use a Primary Dental provider and have met your $50.00 deductible. Gold Crown (procedure 2790): Dentist Charges . . . . . . . . . . . . . . . . $848.00 2021 Benefit Summary. 05/01/21. All members should receive a yearly summary of their benefits. If you did not, or have questions about your Summary, call the Trust. You may also check your benefits online anytime. Click the “ MyBenefits” tab to get started.Dependents OVER 18 need to give their permission for the Benefit Portal: If you have an adult dependent, we need their permission to have their benefit information displayed on the Portal. The reverse is also true. If their information is currently displayed, and they want it removed they need to sign off on that as well. CCPOA Medical Plan Medicare (PPO) Blue Shield of California (800) 776-4466. Yes: You must belong to the specific employee association and pay applicable dues to enroll in the CCPOA. The CCPOA plan is available only to dues-paying members of that organization and their families. CCPOA prescription benefits are administered through Blue Shield of ...Main Office: (916) 779-6355. Claims Dept: (916) 779-6356. Piggyback is a supplemental program provided by the CCPOA Benefit Trust Fund that helps to offset the out-of-pocket expenses incurred from the usage of your Dental, Vision and Hearing Aid programs.only dental program available to you and your Eligible Dependents for the first twelve (12) months of your eligibility for coverage. At the end of this twelve (12) month period, you have a period of sixty (60) days during which you may switch your coverage to the Primary Dental Program offered through the Trust.Call Us (916) 779-6300 FAX: Main Office: (916) 779-6355 Claims Dept: (916) 779-6356. Toll Free: 1-800-In-Unit-6Retired State Employees. If you are a retired State employee, you are eligible to continue enrollment in the State’s Dental Program if you retired within 120 days after your date of separation and you receive a retirement allowance from CalPERS. If you are enrolled in a State-sponsored dental plan, your personnel office will automatically ...To check out a dentist for complaints, contact the state licensing board and ask whether it has ever had to investigate a complaint about the dentist and whether it has ever taken disciplinary action. You should also check the dentist's lic...The California Correctional Peace Officers Association (CCPOA) Primary Dental Program is a fee-for-service discount plan and CCPOA has negotiated with a network of over 17,000 dentists in California, including the Case Dental Group. Within the Primary Dental Program is another program called First Dental Health, available to members in our area ...CCPOA Members in most areas must have Western Dental Plan for the first-time year of employment. After completion of the 12 months, members may choose toward stay enrolled, or elect the CCPOA Primary Dental Download.**** CCPOA Employee’s Share R06 – Western Dental - $35.94 CCPOA Primary - $35.94 ***** CCPOA Employee’s Share S06,M06,E06,C06– CCPOA Primary – Total Premium Deducted From CoBen Allowance (RO5 Employee’s share for the Delta Premier Plan is $13.57/$24.12/$35.12 and to be determined for the PPO plan). Main Office: (916) 779-6355. Claims Dept: (916) 779-6356. Piggyback is a supplemental program provided by the CCPOA Benefit Trust Fund that helps to offset the out-of-pocket expenses incurred from the usage of your Dental, Vision and Hearing Aid programs. CCPOA Primary Dental: Product when thee want a wider driving about dental providers. Choose any provider you wish, Primary Dental pays a percentage of the costs. Traditional Coverage: She may select any dentist where in the world. The Program sets limits (usual and customary amounts) that it will pay for each type of dental handling.When you are enrolled in a CCPOA vision program, you get personalized eye care and the eye wellness care necessary to keep you healthy and on the move. To use your vision benefit, simply contact VSP at 800-877-7195 and ask the VSP representative to assist you with using your VSP benefit.Retired State Employees. If you are a retired State employee, you are eligible to continue enrollment in the State’s Dental Program if you retired within 120 days after your date of separation and you receive a retirement allowance from CalPERS. If you are enrolled in a State-sponsored dental plan, your personnel office will automatically ... The primary functions of the human teeth are obtaining, chewing and breaking down food. Teeth are also responsible for protecting the oral cavity and assisting in speech. They are composed of different parts that have unique functions in th...Dental Western Dental and CCPOA Primary $0.00monthly premium for members Actual rate = $114.00 monthly. $69.06 State Contribution + The Trust will be subsi-dizing the Dental Rates per the BU6 MOU Vision www.vsp.com $0.00monthly premium for members Actual rate = $15.54 monthly. $8.27 State Contribution + The Trust will be subsidiz- Dental Western Dental and CCPOA Primary $0.00monthly premium for members Actual rate = $114.00 monthly. $69.06 State Contribution + The Trust will be subsi-dizing the Dental Rates per the BU6 MOU Vision www.vsp.com $0.00monthly premium for members Actual rate = $15.54 monthly. $8.27 State Contribution + The Trust will be subsidiz-About Us. The Trust was created in 1987. It was originally kept in a shoebox in a members garage. The CCPOA Benefit Trust Fund is a non-profit 501 (c) (9) organization, and now employs 35 staffers providing health, welfare and death benefits to over 40,000 active and retired CCPOA members.to as “Primary Dental Plan”) or after benefits have been paid by any other primary dental plan. (b) Vision Care Program This part of the Supplemental Program provides reimbursement of the deductible and excess frame charges required by your state-paid Primary Vision Plan or the Retired “Standard” Vision Plan through Vision Service Plan.Dental Western Dental and CCPOA Primary 0.00 monthly* *Actual rate = 114.00 monthly. 69.06 State Contribution + The Trust will be Plan – #2561 subsidizing the Dental Rates per the BU6 MOU Use as example only. Your actual costs may very. State contribution rate as of 08/20/21. Rates subject to change after printing. Contribution Formula: 80/80Main Office: (916) 779-6355. Claims Dept: (916) 779-6356. Piggyback is a supplemental program provided by the CCPOA Benefit Trust Fund that helps to offset the out-of-pocket expenses incurred from the usage of your Dental, Vision and Hearing Aid programs. Dental Western Dental and CCPOA Primary $0.00monthly premium for members Actual rate = $114.00 monthly. $69.06 State Contribution + The Trust will be subsi-dizing the Dental Rates per the BU6 MOU Vision www.vsp.com $0.00monthly premium for members Actual rate = $15.54 monthly. $8.27 State Contribution + The Trust will be subsidiz- WHEN: Sign up from September 18–October 13 for benefits effective January 1, 2024. WHERE to go if you want to make changes: Active – contact your personnel specialist during open enrollment and complete the required paperwork. Retired – Contact CalPERS / visit my.calpers.ca.gov to make changes to your medical or dental programs.Dependents OVER 18 need to give their permission for the Benefit Portal: If you have an adult dependent, we need their permission to have their benefit information displayed on the Portal. The reverse is also true. If their information is currently displayed, and they want it removed they need to sign off on that as well. Dental Claims: You or your dentist must submit an itemized claim and an itemized primary insurance statement (EOB) to the CCPOA BTF for reimbursement. Vision Claims: Ask your eye care provider for an itemized statement of your out-of-pocket expenses and submit the statement to the CCPOA BTF for reimbursement. Active: Piggyback Vision Claim FormPrimary Dental - Benefit Breakdown ... NOTICE: You are entering the secure site for CCPOA Dental Providers only. If you are a CCPOA Member and wish to view your benefits online, please visit the "MyBenefits" link in the main menu. SECURE SITE. Provider Portal. ... CCPOA Benefit Trust Fund 2515 Venture Oaks Way Suite 200 Sacramento, CA 95833 ...California Correctional Peace Officers Association (CCPOA) Dental Plans. The CCPOA Benefit Trust Fund (CCPOA BT) administers the Primary Dental (indemnity) and Western Dental (prepaid) plans for dues-paying BU6 employees. The exclusive representative of BU6 contracts directly with its dental carriers through the CCPOA BT for its members ...12 Month CCPOA Western Dental Plan Restriction. All newly hired eligible employees in BU 6 enrolling into dental benefits must enroll into the CCPOA Western Dental plan for 12 months to be eligible for enrollment in the CCPOA Primary Dental plan. Exceptions to this are: Employees who do not have a prepaid plan provider within 50 mile of their home.Transcription . October 7 CCPOA Medical Plan Comparison Charts Coverage MapBook Now. ATTENTION! Online booking system is limited to certain types of appointments & does not reflect all availability. If you require specific times, need a family appointment or see our Hygienists, please contact us. Do not book if you are Covid-19 positive or have other cold and Flu symptoms. COOPERS PLAINS Address 52 Henley Street ...Eligibility for participation in the state's dental benefit program is governed by the California Public Employees' Retirement System's (CalPERS) Public Employees' Medical and Hospital Care Act, which also determines eligibility for participation in the state's health benefit program.When you are enrolled in a CCPOA vision program, you get personalized eye care and the eye wellness care necessary to keep you healthy and on the move. To use your vision benefit, simply contact VSP at 800-877-7195 and ask the VSP representative to assist you with using your VSP benefit.Piggyback is an supplemental programmer granted by which CCPOA Benefit Treuhandfirma Finance that helps toward offset ... Primary Dental - Benefit Breaking Out-Of-Network ... by the CCPOA Help Trust Fund that helps to offset the out-of-pocket expenses incurred from the typical of your Dentistry, Visionary and Hearing Aid programs. ...Primary Dental - Procedure List; More To Know . Experian Security Info 2020 ... CCPOA Benefit Trust Fund 2515 Venture Oaks Way Suite 200 Sacramento, CA 95833 ... $5,000 Accidental Death Accidental Death & Dismemberment Basic Life Dental Programs Gold Shield-DisabilityBenefit Plan Legal Defense Fund Medical Plan -Medical Rates -Teladoc -Wellvolution Piggyback Supplemental Term Life Triada U.S. Legal-Family Defender Vision Plan-VSPYou and your dependents may be eligible for state-sponsored dental insurance and the state offers several dental plans to choose from. Eligible employees may enroll in a dental plan within the first 60 days from their date of hire or the date they became eligible, during the annual Open Enrollment, or when they experience a permitting event.Western Dental Plan Type Covered Persons Single 2-Party Family Standard Employees and Dependents $16.09 $26.54 $37.65 Dental benefits for Bargaining Unit 6 (BU6) employees are provided through the CCPOA Health Benefits Trust. Exception: BU6 employees who are non-CCPOA members may only enroll into Western Dental. STATE …Delta Dental PPO plus Premier Enhanced Plan —Excluded Employees . Group Number: 9949-2101 . Dental Org. Code: 351-008 . Party Code Total Premium . Party Code 1 $ 52.87 Party Code 2 $104.06 Party Code 3 $146.18 . Delta Dental Preferred Provider Option (PPO)—Excluded and Represented Employees . Group Number: 9946 . Dental Org. Code: 351-018 The California Correctional Peace Officers Association (CCPOA) provides dental insurance to BU6 employees who are CCPOA members. All eligible Bargaining Unit 6 employees are required to enroll in a CCPOAplan, unless they have other state-sponsored dental coverage through a spouse or domestic partner. Employees in Bargaining Units 5 and 6 should ...01-4958647 | 01-4961957 | 01-4958312 | 01-4958319 [email protected] Home; Our Story; About . Introduction; Our Team; Products; Career; News; ContactThese dental plans provide dental insurance for all eligible active and retired employees and their eligible dependents except for members of Unit 6, whose dental insurance is provided through the California Correctional Peace Officers Association (CCPOA) Benefit Trust Fund. Who We Are. First Dental Health was founded in 1995 with a common goal in mind: to make affordable dental care. As one of California's largest dental network management companies, now with a national presence, First Dental Health strives to lead the industry in establishing "firsts" in achieving dental cost savings. find a dentist.CCPOA Primary Dental. Primary Dental: Coverage when you want a wider range of dental providers. Choose any provider you wish, Primary Dental pays a percentage of the costs. First Dental Health: is a cost saving network that is a part of Primary Dental Plan. Select a First Dental Health provider and save. Learn about Primary Dentalthe option to elect CCPOA Benefit Trust Fund (BTF) Primary dental plan as well as State sponsored dental plans. Rank and file employees in BU 6 who promote will continue to have the option to remain in their CCPOA Primary dental plan, or change to one of the excluded classifications designated under BU 6.Primary Dental Non-Contracted Provider: First Dental Health Providers: Calendar year maximum: $2000/ per person Combined Dental & Orthodontic Deductible: Calendar year maximum: $2000/per person Per calendar year Deductible: None Individual: $50 Family: $150 Services are payable based on Contract Rate through First Dental Health …• Prior CCPOA Primary Dental plan eligibility as an employee. Dependent Eligibility and Enrollment and Recertification Process : Dependents eligible for dental benefits include the employee’s spouse, registered domestic partner, and their children up to age 26, including natural born, adopted (or children placed for ...01-4958647 | 01-4961957 | 01-4958312 | 01-4958319 [email protected] Home; Our Story; About . Introduction; Our Team; Products; Career; News; Contactenroll and maintain coverage in Western Dental for 12 consecutive months before they can change to the CCPOA’s Primary Dental plan. This stipulation also applies to existing state employees who have recently transferred into BU6 and have previously satisfied the state’s mandated 24-month prepaid dental plan restriction.UNION OFFICES. 1-800-821-6443 755 Riverpoint Drive West Sacramento, CA 95605-1634The CCPOA Medical Plan provides you and your family a great plan with good rates and extensive care. The CCPOA Medical Plan has affordable rates and a large network of providers. Just some of the additional member benefits include: Teladoc ® , 24/7 Nurseline ® , Maven Maternity Program. Wellvolution ®. Network Chiropractic benefits.UNION OFFICES. 1-800-821-6443 755 Riverpoint Drive West Sacramento, CA 95605-1634 As one of California's largest dental network management companies, now with a national presence, First Dental Health strives to lead the industry in establishing "firsts" in achieving dental cost savings. find a dentist >> start your search Call us Today 800.334.7244Thanks to recent advances in dental technology, it’s possible for dentists to create close replicas of teeth that can be implanted into a patients mouth. The cost of teeth implants will vary depending on where they are done and how many tee...Visit the CCPOA website or contact the CCPOA directly to obtain the necessary forms and instructions for filling out the ccpoa primary dental providers. 02 Start by providing your personal information, such as your name, date of birth, and contact details.Primary Dental Non-Contracted Provider: First Dental Health Providers: Calendar year maximum: $2000/ per person Combined Dental & Orthodontic Deductible: Calendar year maximum: $2000/per person Per calendar year Deductible: None Individual: $50 Family: $150 Services are payable based on Contract Rate through First Dental Health …False teeth, also referred to as dentures, are prosthetic teeth that attach to a supportive structure that you can easily remove from your mouth. Finding cost-effective false teeth with a little research is possible.Since 1998 Western Dental Plan has been the cost effective dental plan offered through the CCPOA Benefit Trust Fund. If you have any questions about your plan, please call 800-992-3366. Plan Summary. Your plan includes comprehensive dental benefits with no deductibles and no claim forms. Plus, you can choose from a full network of private ...**** CCPOA Employee’s Share R06 – Western Dental - $35.94 CCPOA Primary - $35.94 ***** CCPOA Employee’s Share S06,M06,E06,C06– CCPOA Primary – Total Premium Deducted From CoBen Allowance (RO5 Employee’s share for the Delta Premier Plan is $13.57/$24.12/$35.12 and to be determined for the PPO plan). These dental plans provide dental insurance for all eligible active and retired employees and their eligible dependents except for members of Unit 6, whose dental insurance is provided through the California Correctional Peace Officers Association (CCPOA) Benefit Trust Fund. These dental plans provide dental insurance for all eligible active and retired employees and their eligible dependents except for members of Unit 6, whose dental insurance is provided through the California Correctional Peace Officers Association (CCPOA) Benefit Trust Fund. The California Correctional Peace Officers Association (CCPOA) Primary Dental Program is a fee-for-service discount plan and CCPOA has negotiated with a network of over 17,000 dentists in California, including the Case Dental Group. Within the Primary Dental Program is another program called First Dental Health, available to members in our area ...Dental charges for fillings are one of the common expenses associated with keeping your teeth healthy and strong. Check out this guide to the cost and types of dental fillings available to you.We would like to show you a description here but the site won’t allow us.Dec 27, 2022 · The California Correctional Peace Officers Association (CCPOA) provides dental insurance to BU6 employees who are CCPOA members. All eligible Bargaining Unit 6 employees are required to enroll in a CCPOAplan, unless they have other state-sponsored dental coverage through a spouse or domestic partner. Employees in Bargaining Units 5 and 6 should ... Enhanced Dental, Vision and Hearing Aid Coverage Here is an example of how Piggyback works This is only an example of coverage. Example based on CCPOA Primary Dental benefits and assumes you use a Primary Dental provider and have met your $50.00 deductible. Gold Crown (procedure 2790): Dentist Charges . . . . . . . . . . . . . . . . $848.00CCPOA/Primary Dental (R06) Fee-For-Service 351-006. CCPOA/Western Dental (R06) Group Number: Prepaid. Dental Org. Code: 351-249. CCPOA/Primary Dental (S06, M06, E06, C06) Group Number: Fee-For-Service. Dental …For employees enrolled in the CCPOA Primary Dental plan at the time they change from a R06 position to an S06, M06, C06 or E06 position, they may continue their coverage in the CCPOA Primary Dental plan without further action. They will also have 60 days to choose a State-sponsored dental plan should they want to change their dental plan. Having good oral hygiene is important. But even if you regularly brush and floss, you may find yourself needing a dental implant. Some may be deciding whether to go for dental implants or dentures as both have their pros and cons.For Western Dental: Western Dental Attn: COBRA UNIT 530 South Main Street, 6th Floor Orange, CA 92868 (866) 859-7525. Union Trust Dental Plans. For Bargaining Unit 6 - CCPOA/Primary Dental (R06), CCPOA/Western Dental (R06), and CCPOA/Primary Dental (S06, M06, E06, C06): CCPOA Benefit Trust Fund 2515 …Jan 1, 2023 · CCPOA Benefit Trust Fund Primary Dental Program Highlights PD_PlanHighlights.v2_2023 Q123R05 Preventive/Diagnostic Services 100% Prophy: Three times in the calendar year (anytime) Fluoride: Unlimited for dependents 14 and under. Sealants: No age limit, on permanent unrestored posterior molars only - Once every 36 months Thanks to recent advances in dental technology, it’s possible for dentists to create close replicas of teeth that can be implanted into a patients mouth. The cost of teeth implants will vary depending on where they are done and how many tee...Enhanced Dental, Vision and Hearing Aid Coverage Here is an example of how Piggyback works This is only an example of coverage. Example based on CCPOA Primary Dental benefits and assumes you use a Primary Dental provider and have met your $50.00 deductible. Gold Crown (procedure 2790): Dentist Charges . . . . . . . . . . . . . . . . $848.00 May 18, 2022 · For Western Dental: Western Dental Attn: COBRA UNIT 530 South Main Street, 6th Floor Orange, CA 92868 (866) 859-7525. Union Trust Dental Plans. For Bargaining Unit 6 - CCPOA/Primary Dental (R06), CCPOA/Western Dental (R06), and CCPOA/Primary Dental (S06, M06, E06, C06): CCPOA Benefit Trust Fund 2515 Venture Oaks Way, Suite 200 Sacramento, CA 95833 Primary Dental. Active Brochure. View. Download PDF. Active Plan Highlights. View. ... CCPOA Benefit Trust Fund 2515 Venture Oaks Way Suite 200 Sacramento, ...Primary Dental - Benefit Breakdown ... You are entering the secure site for CCPOA Dental Providers only. ... CCPOA Benefit Trust Fund 2515 Venture Oaks Way Suite 200 ... Dec 27, 2022 · The California Correctional Peace Officers Association (CCPOA) provides dental insurance to BU6 employees who are CCPOA members. All eligible Bargaining Unit 6 employees are required to enroll in a CCPOAplan, unless they have other state-sponsored dental coverage through a spouse or domestic partner. Employees in Bargaining Units 5 and 6 should ... Primary Get directions Employees at CCPOA Benefit Trust Fund ... Delta Dental Ins. Insurance San Francisco, California Pinnacle Advocacy ... CCPOA Benefit Trust Fund | 84 followers on LinkedIn. ...to $51.60 for the CCPOA Primary Dental and the CCPOA Western Dental Plans effective April 1, 2008. This change will be reflected on the April 1, 2008 pay warrant (March 2008 pay period). This change raises the composite rate from $86.13 to $95.93. Only the CCPOA BT dental plan rates are affected and the CCPOA BT has12 Month CCPOA Western Dental Plan Restriction. All newly hired eligible employees in BU 6 enrolling into dental benefits must enroll into the CCPOA Western Dental plan for 12 months to be eligible for enrollment in the CCPOA Primary Dental plan. Exceptions to this are: Employees who do not have a prepaid plan provider within 50 mile of their home.Dependents OVER 18 need to give their permission for the Benefit Portal: If you have an adult dependent, we need their permission to have their benefit information displayed on the Portal. The reverse is also true. If their information is currently displayed, and they want it removed they need to sign off on that as well.California Correctional Peace Officers Association (CCPOA) Dental Plans. The CCPOA Benefit Trust Fund (CCPOA BT) administers the Primary Dental (indemnity) and Western Dental (prepaid) plans for dues-paying BU6 employees. The exclusive representative of BU6 contracts directly with its dental carriers through the CCPOA BT for its members ...CCPOA/Primary Dental (S06, M06, E06, C06) Group Number: Fee-For-Service Dental Org. Code: 351-246 Party Code Total Premium Party Code 1 $37.00 Party Code 2 $79.00 Party Code 3 $135.00 State-Sponsored Vision Plans VSP Basic Plan Group Number: 30052011 Vision Org. Code: 475-001 (Non–CoBen) or 475–002 (CoBen)
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Charcot-Marie-Tooth disease is a group of disorders passed down through families that affect the nerves outside the brain and spine. These are called the peripheral nerves. Charcot-Marie-Tooth disease is a group of disorders passed down thr...Corporate Office. First Dental Health 5771 Copley Drive #101 San Diego, CA 92111Dogs do indeed have lips. The pendulous upper lips in some breeds are called flews. In addition to their primary function of protecting the teeth, dogs’ lips are also used to send signals via body language and to help channel scents to the ...CCPOA Primary Dental Fee Schedule for Out-Of-Network Providers Effec@ve December 2017 NUMBER DESCRIPTION COST D0120 Periodic Oral Evaluation $47.00 D0140 Limited Oral Evaluation $71.00 D0150 Comprehensive Oral Evaluation - New or Established Patient $83.00 D0160 Detailed and Extensive Oral Evaluation - Problem Focused, by …CCPOA Benefit Trust, union-sponsored dental plans. Employees in these classes will be allowed to make dental plan changes into a CCPOA Benefit Trust plan during the 2011 open ... on their eligibility to enroll into the CCPOA Primary Dental plan. PML 2011-038 10/11/2011 Page 2. STATE OF CALIFORNIA .The web page provides policy updates, eligibility and enrollment information, and enrollment forms for the state's dental insurance program. It covers the dental plans for state employees, retirees, and their dependents, as well as the dental benefits for exempt employees and retirees. It also lists the dental carriers and the CCPOA benefit trust fund.Striving to lead the industry with "firsts" in affordable dental care. Founded in 1995, First Dental Health ® is one of California's largest dental network management companies that also boasts an international presence. With a focus on reducing dental care costs backed by a long history of creating and managing industry-leading dental ...CCPOA PRIMARY DENTAL CCPOA s Fee-for-Service Procedure Code List Effective May 2016 We have provided these payment allowances for informational purposes only and not as a guarantee of payment. All claims . More information . NAPCS Product List for NAICS 62121 (US, Mex): Offices of Dentists.CCPOA Primary Dental: Coverage when you want a wider range of dental providers. Choose any provider you wish, Primary Dental pays a percentage of the costs. Traditional Coverage: You may select any dentist anywhere in the world. The Program sets limits (usual and customary amounts) that it will pay for each type of dental treatment. the option to elect CCPOA Benefit Trust Fund (BTF) Primary dental plan as well as State sponsored dental plans. Rank and file employees in BU 6 who promote will continue to have the option to remain in their CCPOA Primary dental plan, or change to one of the excluded classifications designated under BU 6.Piggyback is a supplemental program provided by the CCPOA Benefit Trust Fund that helps to offset the out- of-pocket expenses incurred from the usage of your Dental, Vision and Hearing Aid programs. Piggyback pays a portion of the fees your dentist charges, after benefits have been paid by your primary dental program.The Western Dental Services, Inc. (“Program”) is a prepaid dental program sponsored by the CCPOA Benefit Trust Fund (“Trust”), which uses a closed panel of providers. The Program is a component of the CCPOA Benefit Trust Fund Health and Welfare Plan. IMPORTANT NOTE TO NEW HIRES: Mandatory Enrollment in the Prepaid Dental ProgramCCPOA/Primary Dental (S06, M06, E06, C06) Group Number: Fee-For-Service Dental Org. Code: 351-246 Party Code Total Premium Party Code 1 $37.00 Party Code 2 $79.00 Party Code 3 $135.00 State-Sponsored Vision Plans VSP Basic Plan Group Number: 30052011 Vision Org. Code: 475-001 (Non–CoBen) or 475–002 (CoBen)A free benefit that pays your beneficiary Five Thousand Dollars ($5,000) upon your death as a result of a accident. The program provides coverage in addition to other insurance or ERISA benefits which may be payable upon your Accidental Death.Then your dental plan enrollment contact is: And your dental benefits administrator is: State: CalPERS - Call 888 CalPERS (or 888-225-7377) 1. CalHR: CSU: CalPERS - Call 888 CalPERS (or 888-225-7377) 1. CSU Retirement Benefits: Public Agency: The personnel office of the agency you retired from: The personnel office of the agency you retired fromDental Claims: You or your dentist must submit an itemized claim and an itemized primary insurance statement (EOB) to the CCPOA BTF for reimbursement. Vision Claims: Ask your eye care provider for an itemized statement of your out-of-pocket expenses and submit the statement to the CCPOA BTF for reimbursement. Active: Piggyback Vision Claim Form .
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