• 501. General Information
• 502. Current State-Sponsored Dental Plans
• 503. Responsibilities
• 504. Dental Plan Deduction Codes/Premiums
• 505. Employee Eligibility
• 506. Intentionally Unused
• 507. 24 Month Plan Restriction
• 508. Dependent Eligibility
• 509. Intentionally Unused
• 510. Enrollment
• 511. Allowable Changes To Enrollment
• 512. Effective Dates
• 513. Re-Enrollment Of Employees
• 514. Annual Open Enrollment Period
• 515. Continuation of Coverage While Off Pay Status
• 516. 120-Day Survivor Death Benefit For Continuation Of Benefits
• 517. Retiring Employees
• 518. Cancellation/Termination Of Dental Enrollment/Coverage
• 519. Consolidated Omnibus Budget Reconciliation Act (COBRA)
• 520. Document Completion
• 521. Dental Carriers/Benefit Information

• View all Section 500

  Attachments

• Attachment A - Dental Plan Enrollment Authorization (Std. 692)
• Attachment B - Dental Deduction Codes/Premiums
• Attachment C - Permitting Events Code Chart
• Attachment D - Affidavit of Eligibility
• Attachment E - HDB-34
• Attachment F - Dental Plan Direct Payment Authorization (Std. 696)
• Attachment G - Affidavit of Eligibility - Domestic Partner (DPA 680)
• Attachment H - Instructions for Completion of Dental Plan Enrollment Authorization (Std. 692)
• Attachment I - Examples of Completed Std. 692
• Attachment J - Delta Form 602A (blank form)
• Attachment J1 - Delta Form 602A (example)

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• Table of Contents

502. Current State-Sponsored Dental Plans

Currently the State of California has contracts with four dental carriers; Delta Dental for an indemnity plan referred to as Delta Dental Premier, and the Delta Preferred Provider Option (PPO) plan which is the preferred provider option plan, and two prepaid plans; Private Medical Care, Inc. (PMI), and SafeGuard. These four plans provide dental insurance for all eligible active and retired employees and their eligible dependents, with the exception of employees in Unit 6 that have their dental insurance provided through their respective union-sponsored trust. In addition, Unit 5 employees that are also members of the California Association of Highway Patrolmen (CAHP) have their own indemnity dental plan, but may enroll in any of the four State-sponsored prepaid plans.

The following provides a brief description of the three types of dental plans available; prepaid, preferred provider option and indemnity:

A prepaid plan requires that the enrollee choose a dentist from a specific list of dentists who contract with each prepaid dental company. These dentists make up what is referred to as the dental carrier's provider network. Dentists are paid a flat monthly fee by the plan for each member assigned to their offices. Most basic services are covered at no cost to the enrollee.

The monthly premium is fully paid by the State and no premium deduction is taken from the monthly pay warrant of the employee.

Delta Preferred Provider Option (PPO), a preferred provider option plan allows enrollees to select any licensed dentist for services. However, enrollees receive the maximum benefit available under the program when they choose one of the plan's in-network dentists. Enrollees get the best benefit when they visit an in-network dentist. Similar to the indemnity plan, individuals who enroll in the plan are required to pay a monthly premium co-payment.

Delta Dental Premier, an indemnity plan does not use a provider network like the prepaid or preferred provider plans. Enrollees are allowed to select the dentist of their choice. With an indemnity plan there are set limits that the plan will pay for each specific type of dental treatment. Enrollees are responsible for paying any remaining balance that might be due based on the type of dental treatment provided. The State pays a portion of the monthly premium with the balance deducted from the monthly pay warrant of the employee.