Dental Plan

A.F.S.C.M.E. LOCAL 641 HEALTH & WELFARE FUND

Contact Person: Nancy Carvalho          [email protected]

OPEN ENROLLMENT/DENTAL INSURANCE RATES

EFFECTIVE MARCH 1, 2022

AVAILABLE ONLY TO EMPLOYEES/AFSCME MEMBERS IN GOOD STANDING OR PARAPROFESSIONAL UNION MEMEBERS IN GOOD STANDING

       NEW MEMBERS MUST REMAIN IN PLAN FOR ONE FULL YEAR, BEFORE CANCELLING

       CURRENT DENTAL MEMBERS MAY CHANGE OR CANCEL COVERAGE AT THIS TIME

APPLICATIONS & SUMMARY OF BENEFITS ARE AVAILABLE IN PAYROLL, RM. #136, (PRAB, 455 COUNTY STREET)

       INDIVIDUAL COVERAGE:        $25.00 BI-WEEKLY (TOTAL $475.00/YEAR)*

*Excluding February, April, & Summer vacation weeks

       FAMILY COVERAGE:               $64.00 BI-WEEKLY (TOTAL $1216.00/YEAR)*

*Excluding February, April, & Summer vacation weeks

THERE IS A $15.00 ADMINISTRATIVE FEE FOR ALL NEW MEMBERS – IT WILL BE DEDUCTED FROM YOUR FIRST DENTAL DEDUCTION, WHICH WILL BEGIN IN FEBRUARY, 2022

APPLICATIONS FOR NEW MEMBERS** MUST BE SUBMITTED BEFORE, BUT NO LATER THAN, MONDAY, JANUARY 14, 2022

**Exception:  Newly hired employees must apply within 30 days of hire date or wait for next year’s Open Enrollment period.