TWU Local 100 / Healthplex Dental Plan Documents

Welcome to your Healthplex Dental Benefit Information pageIB Image
*You will not find information about Local 100’s dental benefits in your Business Service Center, (BSC) MTA Portal.

For information regarding your Healthplex Dental coverage, continue reading below. Once your benefits become active (90 days after your hire date) visit www.healthplex.com to register by clicking on I Have a Plan (I am a Member). Once registered, you can:

  • Review Plan Details
• Check dependents on your plan
• Check Your/Dependent Eligibility		 • Check Status of a Claim
• View/Print ID Card
• Find a Dentist

To speak with a TWU Local 100 Healthplex representative, call 1-(844) 898-4759.

*Annual Enrollment Change Period is October 15 – November 15”
Which plan is best for you?
  COMPREHENSIVE (Managed Care)
Plan Group-GG-668M01		 PPO Plan*
Plan Group-GG-668P01
BENEFITS In-Network benefits only In and Out-of-Network benefits
PROVIDERS In-Network only Comprehensive Panel In and Out-of-Network Metro Panel
GENERAL DENTIST Same provider for all family members Individual selections permitted
CO-PAYMENTS Non for covered services In-Network None for covered services In-Network
ANNUAL MAXIMUM BENEFIT NONE $1,800 per person
$3,600 per family
(only applies to member and dependents who are 19 or older)
DEDUCTIBLE NONE NONE
CLAIM FORMS NONE Yes - claims forms needed
REFERRALS YES, for specialty services No
NON-PARTICIPATING REIMBURSEMENT NONE Yes - based on specific fee schedule (link)
ORTHODONTIA Orthodontia covered to age 26 as long as patient has been fully banded prior to age 23 Orthodontia covered to age 26 as long as patient has been fully banded prior to age 23
IMPLANTS Implants and implant related service covered up to an annual maximum of $1,000 per covered life Implants and implant related service covered up to an annual maximum of $1,000 per covered life
•Dental plans underwritten by Dentcare Delivery Systems, Inc.

Important Forms (Downloadable)
*Adding or removing dependents may require verification documents such as: (ie.Birth Certificate, Marriage Certificate).

Schedule of fees: Managed Care • PPO

FOR RETIREES ONLY: You have the right to enroll in COBRA.

  • Download and complete the COBRA Form
  • Attach verification of your official retirement date, NYCERS Form: F541 or a Time Allowance Record may be used.

All forms and verification documents must be:
Emailed: member.services@twulocal100.org or
Faxed: (347) 643-8063 or
Walk in: 180 Livingston Street. 4th Floor, Room 4017 Brooklyn, NY 11201

*For any further assistance or issues, contact TWU Local 100 Member Services Department at: Tel: (347) 643-8060, 61, 62, 64, 66, 67, 68, 69

Certificate of Insurance