You offer two types of Dental Coverage: One for folks who already have basic dental coverage and one for those who have little or none. Is it the same with Vision Care?
No. When it comes to Vision Care, we have a single plan that’s great for everyone!

I already have vision coverage through Medicaid or the Essential Plan 3 or 4. It’s ok but not great. How does this vision care coverage compare to that?
We deliberately designed this plan to be a step up from what Medicaid and the Essential Plan 3 and 4 offer (FYI: The Essential Plans 1 and 2 offer little or no vision coverage at all).

What services are covered?
Annual eye exams plus allowances for contact lens fittings. In addition, a $130 annual allowance for frames and 20% off anything spent above that amount. A wide variety of lens options are available (with copays ranging from $0 to $40). An annual contact lens allowance is also available (in lieu of glasses) and discounts on laser corrective surgery. For the full details, check out the Benefits Summary. 

Are there copays?
For the base offerings and services, no. For some items, yes. For the full details, check out the Benefits Summary.

What eye care providers can I see?
Unlike the dental plans, you must see an in-network provider to leverage your vision benefits. Find a list of in-network vision providers near you.

Who are these services for?
Anyone with existing dental benefits at the level provided by Medicaid or the Essential Plan 3 / 4 (or better).

What services are covered?
Everything in the Basic Plan (see above) PLUS implants and orthodontia. The annual limits are such that you can get a full set braces (including all follow-up visits and hardware) and as many as 2-3 implants annually (assuming you don’t have substantial other work done the same year). For full details, check out the Tier II Benefits Summary.

Which services are not covered?
The following services are not covered:

• Cosmetic surgery and treatment unless it is reconstructive surgery caused by trauma, infection, or disease of the involved part.
• Prescription drugs and medicines.
• Services and appliances for the treatment of temporomandibular joint (TMJ) dysfunction.
• Transplantations.

Is there a deductible I have to hit before the health insurance starts paying?
There is a $0 deductible meaning you don’t have to pay anything before the coverage we provide kicks in!

Are there copays or co-insurance?
No. So long as you see an in-network dentist, the plan covers the full expense of all covered services.

What dentists can I see?
You can see any dentist you like with one caveat: As a Preferred Premier Dental Plan, you have access to a network of more than 10,000 dentists and specialists in New York and New Jersey. While you can visit either an in-network or out-of-network dentist, when you visit an in-network dentist, you can be certain that the insurance we provide you with will cover 100% of the set dollar amount for the service or 100% of the bill (depending on the service). When you see an out-of-network dentist, the health insurance provider will pay the full amount they’d pay to an in-network dentist but if your out-of-network dentist charges more than that, you’ll have to pay the difference. Search for an in-network dentist by specialty in your area. 

Who are these services for?
Anyone with little or no existing dental coverage.

What services are covered?
Everything you would expect out of a dental plan, including:

- Preventive & Diagnostic Services – Examinations, cleanings, x-rays, & tests and labs
- Basic Services – Simple Extractions, fillings, endodontics, anesthesia
- Major Services – Prosthetics, restorations, and oral surgery up to an annual maximum of $2,000 in services.

For full details, check out the Tier I Benefits Summary

Which services are not covered?
The following services are not covered:

- Cosmetic surgery and treatment unless it is reconstructive surgery caused by trauma, infection, or disease of the involved part.
- Prescription drugs and medicines.
- Services and appliances for the treatment of temporomandibular joint (TMJ) dysfunction. iv. Transplantations.

Is there a deductible I have to hit before the health insurance starts paying?
There is a $0 deductible meaning you don’t have to pay anything before the coverage we provide kicks in!

Are there copays or co-insurance?
No. So long as you see an in-network dentist, the plan covers the full expense of all covered services.

What dentists can I see?
You can see any dentist you like with one caveat: As a Preferred Premier Dental Plan, you have access to a network of more than 10,000 dentists and specialists in New York and New Jersey. While you can visit either an in-network or out-of-network dentist, when you visit an in-network dentist, you can be certain that the insurance we provide you with will cover 100% of the set dollar amount for the service or 100% of the bill (depending on the service). When you see an out-of-network dentist, the health insurance provider will pay the full amount they’d pay to an in-network dentist but if your out-of-network dentist charges more than that, you’ll have to pay the difference. Search for an in-network dentist by specialty in your area.

Will I have to provide financial documents in order for Provider Wellness to determine what level of benefits I qualify for?
No. Provider Wellness is open to all NYC-based family child care providers with at least one HRA/ACS child in care, regardless of income. The only place your income comes into play is that it may impact what health insurance you already have (e.g. Medicaid, Essential Plan, Qualified Health Plan from the marketplace) independent of Provider Wellness and that will impact which of our two Dental Care options make most sense for you. That said, we will not be asking for or reviewing your financial documents to determine which Dental Care plan to enroll you in (should you choose to enroll in the Dental Care plan at all). Instead, we simply ask you to share with us what type of insurance you currently have so we can provide you with the correct dental coverage.

Will participating in Provider Wellness affect my taxes/income, Medicaid, or any other form of public assistance I receive?
No. This will not affect those in any way. The benefits you receive through Provider Wellness are not considered income and therefore will not affect your taxes, eligibility for Medicaid, or eligibility any other income-based form of public assistance.

Will participating in Provider Wellness affect my existing insurance?
No. Any insurance-related benefits from Provider Wellness are considered secondary insurances. Your existing insurance (if any) will pay first and then the Provider Wellness coverage will take over after that. Your existing insurance provider (if any) does not need to know about (and likely will not know about) your Provider Wellness benefits.

Who is eligible for Provider Wellness?
Any NYC-based family child care provider – whether Family Day Care, Group Family Day Care or Legally Exempt (informal) – with at least one HRA/ACS child under care is eligible.

What about my assistants? Are they eligible?
No. Assistants are not eligible for Provider Wellness at this time.

What about members of my family/household? Are they eligible?
The benefits in Provider Wellness are only available to the provider themselves. The only exception is that if you go onto the NY State of Health Marketplace (health insurance exchange), you may purchase a health insurance plan that covers your whole family and the premiums that you pay for that plan will be eligible for reimbursement through the Provider Wellness Marketplace Premium Reimbursement benefit, subject to the limitations of that benefit (see below for more information).

Do I have to be a member of the UFT Family Child Care Provider chapter of the union in order to participate in Provider Wellness?
No, but Provider Wellness only exists thanks to the tireless advocacy of the union on behalf of family child care providers like you. If you find you’re getting at least $21/month worth of benefits from Provider Wellness – and we’re fairly certain you’ll get much more than that – we would urge you to help support us in our work supporting you by joining. Learn more about the benefits and how to join.

What is Provider Wellness?
Provider Wellness is an initiative funded by the NYS Department of Health and the United Federation of Teachers (UFT), and designed and operated in the five boroughs of New York City by the UFT whose purpose is to improve the health and wellbeing of NYC-based family child care providers.

What does Provider Wellness cost?
Provider Wellness is 100% cost-free for its participants. If you’re eligible to participate, you can receive whichever benefits apply to you at no cost.

Who provides the services/benefits in Provider Wellness?
The benefits are provided by Emblem Health (Dental/Vision), WellSpark Health (Lifestyle Coaching & Wellbeing Resources), the UFT Member Assistant Program (Mental Health Services), the UFT (Premium Reimbursement program).

What languages (besides English) does Provider Wellness support?
On the administrative side, our main Provider Wellness information line is managed by individuals fluent in both English and Spanish. In addition, we utilize a live interpretation service that allows us to provide assistance and support (including assistance enrolling in Provider Wellness or signing up for any specific benefits) in more than 150 languages.

On the programmatic side, the support is as follows:

• Dental/Vision Care: In addition to helping you enroll, the extensive network of providers includes one or more who are conversant in English, Spanish, Mandarin, Russian, and French. Other languages may be supported but these were the ones we researched.
• Premium Reimbursement: As this is simply a paper-work benefit, our administrative staff can assist providers in more than 150 languages in assembling and submitting the correct paperwork to receive these reimbursements.
• Mental Health Services: Without interpretation, these services are primarily available exclusively in English at this time. If you are comfortable with an interpreter in the conversation, we can support more than 150 languages. We are also planning to bring on a Spanish-speaking counselor in the near future.
• Lifestyle Coaching & Wellbeing Resources: Coaching is available now in English, Spanish, Russian, and Mandarin and can be expanded to include Haitian Creole and French if sufficient demand materializes.

¿Si tengo Medicaid o alguno de los planes esenciales Essential Plans que ofrece el edo. de NY, o no tengo ningún seguro médico, tengo derecho a esta cobertura?
No. Esta cobertura no se aplica a ti porque no estás pagando ninguna prima para tu seguro médico, ya sea porque no tienes ningún seguro médico o porque tienes Medicaid o alguno de los Essential Plans, y ninguno de estos tiene primas asociadas. Como resultado, no tenemos nada qué reembolsarte.

Yo tengo seguro a través de mi empleador o del empleador de mi pareja. ¿Tengo derecho a este beneficio?
No. Este beneficio te reembolsará los gastos que pagues de tu bolsillo (esto es, tus “primas”) para comprar un plan médico calificado dentro del mercado de seguros llamado “NY State of Health”. En cambio, las primas que usted y su familia pagan para compensar el costo del plan a través del empleador que tú tienes no califican para ser reembolsadas a través de este programa.

¿Cuánto me reembolsarán de mis primas?
Provider Wellness te reembolsará hasta el 100% de las primas que tú pagaste de tu bolsillo, con las siguientes limitaciones: 1) durante el actual año cubierto (de oct. 2022 a sept. 2023) hay un límite de $400.00 al trimestre para cada proveedor de cuidado infantil; 2) los fondos destinados a esta cobertura no son ilimitados, y serán entregados por orden de solicitud, hasta que se acaben.

¿Se me pueden reembolsar también mis gastos médicos pagados de mi bolsillo?
No. Este beneficio sólo te reembolsa el costo de compra de seguro médico (es decir, las “primas”), no los costos en los que usted incurras por servicios médicos (es decir, las contribuciones de pago, contribuciones de seguro, desembolsos antes de alcanzar tu deducible, cualquier otro gasto personal relacionado con tu salud).

¿Cómo aprovecho esta beneficio?
Inscríbete en Provider Wellness y elige este beneficio en la página de selección de beneficios llamada Benefits Selection. Recibirás un mensaje electrónico con las instrucciones que te dirán exactamente lo que necesitas hacer para aprovechar este beneficio. Conozca más sobre los detalles de este programa.

¿Esta cobertura se ofrece en persona o de manera virtual?
Esta cobertura se ofrece 100% virtual.

¿Qué tipos hay de asesoría?
Hay dos tipos: individual (atención de persona a persona) y en grupo. Tú puedes utilizar tantas o tan pocas sesiones de uno a uno como quieras, y las puedes programar a horarios convenientes para ti. Las sesiones grupales se organizan con un grupo de compañeras proveedoras (un mínimo de 3 y un máximo de 15), y consisten en reuniones de 30 minutos que tienen lugar una vez a la semana, en la tarde-noche. Lea más detalles sobre este programa.

He sabido de las compensaciones que dan por participar. ¿De qué se tratan?
Quien quiera que termine seis sesiones individuales o un programa completo de doce sesiones grupales recibirá una tarjeta prepagada de $50.00. Aunque los participantes pueden gozar de los beneficios de más de esas sesiones individuales y grupales en un año, sólo tienen derecho a una tarjeta prepagada de compensación cada año. Además, como incentivo para animar a la participación por adelantado, estamos haciendo una serie de rifas en las que sorteamos tarjetas de regalo de Amazon de $100.00 entre cualquiera que simplemente se haya registrado en la plataforma WellSpark y también estamos regalando tarjetas prepagadas de Amazon de $25.00 al primer lote de cuidadoras que se inscriban para recibir asesoría técnica, ya sea individual o en grupo.

The Lead Teacher Assistant is an annual position for in-service, full-time paraprofessionals that enables them to play a more diverse role supporting student needs in the classroom and school. Lead Teacher Assistants support instruction in the classroom under the supervision of the classroom teacher. This position allows paraprofessionals to enhance their skills and can serve as a pathway to a teaching career. If hired as a Lead Teacher Assistant, the paraprofessional will receive additional compensation of $5,000. Paraprofessionals revert to their previous title and base salary at the end of the school year unless they are rehired in the new position. This position is available to full-time paraprofessionals who hold a bachelor’s degree and a state Teacher Assistant certification (any Level I, II or III). 

For more information, read the Lead Teacher Assistant Q&A for paraprofessionals or see more information about the Lead Teacher Assistant and other programs for paraprofessionals on the the DOE’s web page , or read more about career programs and incentives for paraprofessionals. 

The DOE will reimburse eligible full-time paraprofessionals for the cost of up to 12 credits towards a master’s degree in education. Paras must be in an accredited graduate education program as a fully matriculated student leading to New York State teacher certification. Applicants must have at least one full year as a paraprofessional in New York City public schools and be a full-time para at the time of application and for the remainder of the school year. The deadline to apply for reimbursement this school year is Friday, March 31. Learn more about the Paraprofessional to Teacher Pathway Graduate Reimbursement Program and other career programs for paraprofessionals on the DOE website: http://www.teachnycprograms.net/getpage.php?page_id=84. 

Read more about career programs and incentives for paraprofessionals.