Application
If you would like to enroll in coverage, complete the Membership Application and enclosed Enrollment Form.
Retiree Member App Enrollment FormMassachusetts Employers/SEIU Local 888 Health and Welfare Fund effective 1/1/2025 dental coverage for Retiree’s.
This is to notify you that the Annual Open Enrollment period for the BCBS Dental Plan will run from November 1, 2024, through November 22, 2024. Open Enrollment is the only opportunity to enroll in coverage or make a change to your current coverage without a qualifying event for 2025.
In-Network | Out of Network | |
---|---|---|
Preventive | 100% Coverage | 80% Coverage |
Basic | 80% Coverage | 65% Coverage |
Major | 50% Coverage | 40% Coverage |
Ortho | Not Covered | Not Covered |
Employee | $46.75 |
Employee + One | $99.60 |
Family | $134.75 |
Please include the monthly premium payable to: MA Employers H&W Fund. Once enrolled, you will receive a coupon booklet for ongoing premium payments.
You can provide your enrollment form in any of the following ways:
If you have any questions, please do not hesitate to contact Linda DeLuca, Fund Director, at 617-241-3367.
If you would like to enroll in coverage, complete the Membership Application and enclosed Enrollment Form.
Retiree Member App Enrollment Form