Community Blue Reaches Agreement On Dental Benefit

Attorney General Spitzer today announced an agreement with Community Blue to provide better notice about dentists in its Dental Discount Program who provide a free second annual dental examination, and to offer restitution to consumers who tried but were unable to obtain a promised free second examination.

"Community Blue has done the right thing," said Attorney General Spitzer. "In its consumer materials, the company did not make clear that only some of its participating dentists offered the free second annual exam. It's only fair that Community Blue make this clear to consumers, and provide restitution for those who may have been misled."

The case started in mid-2000 when the Attorney General's Health Care Bureau received a complaint from a consumer who said that she had relied upon Community Blue materials touting a free second annual dental exam when her family dropped another dental plan that her husband's employer offered. Her dentist was listed in Community Blue's directory as participating but, to her dismay, the dentist charged her for the second exam.

The Health Care Bureau investigated the complaint by telephoning each dentist listed as participating in Community Blue's Dental Discount Program. The Health Care Bureau found that of the 205 participating dentists listed, only 18 confirmed that they would give the free second annual dental exam.

Following an inquiry from the Health Care Bureau, Community Blue conducted its own investigation and acknowledged that not all dentists listed in its directory of participating dentists had agreed to give a free second annual exam.

Community Blue noted that its directory of participating dentists included an asterisk next to the name of certain listed dentists. But the directory failed to state that only the dentists designated by an asterisk would provide the second free exam. Community Blue further concluded that many of the dentists who told the Health Care Bureau that they would not give a free second annual exam had, in fact, signed an agreement with Community Blue to do so.

In response to the Attorney General's investigation, Community Blue revised its participating provider directory to clearly indicate which dentists offer the free second annual exam. Community Blue also contacted those participating dentists who had agreed to provide the free second annual dental exam to remind them of their obligation to do so.

"When my office notified Community Blue of the problem, the company took steps to remedy the situation," said Attorney General Spitzer.

Under the agreement with the Attorney General's Office, Community Blue will:

  • Reimburse Community Blue members who paid for a second dental exam they received prior to April 2001. Members must show that they were billed and paid for a second annual dental exam by a participating dentist. Members must also show that they did not have other dental coverage at the time;

  • Clearly identify in all future consumer materials those Community Blue dentists who provide a free second annual dental exam, if not all dentists do so;

  • Notify all Community Blue members in its next member newsletter that not all dentists listed in its earlier participating directory provided the free second annual dental exam.

Community Blue serves approximately 300,000 people in western New York State.

This case was handled by Health Care Bureau Albany Section Chief Troy Oeschner with assistance from Assistant Attorneys General Heather Rubinstein and Susan Kirchheimer under the supervision of Health Care Bureau Chief Joe Baker.

Consumers may contact the Health Care Bureau's toll-free hotline at (800) 771-7755 (option #3 on the automated voice menu).
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