507. State Dental Plan Restriction for Newly Hired State Employees
24 Month Plan Restriction
All eligible newly hired represented employees in Bargaining Units 1
through 21, (except Units 2, 7, 8, 16, 17, 18, 19, and excluded
employees), are required to select their dental plan coverage from one of the
two available State-sponsored prepaid dental plans. Impacted employees
may select only a prepaid plan until they have completed 24 months of
employment without a permanent break during the 24 month qualifying
period. At the end of the 24-month period, those employees that elected a
prepaid plan will have 60 days to change their enrollment to Delta
Dental Premier or Delta Preferred Provider Option (PPO), (Delta Dental
Plans). Those employees that chose not to enroll in a prepaid dental plan
may elect Delta Dental, within 60 days after completing the restriction
period, unless they enrolled in the FlexElect cash option for dental.
All eligible employees who reinstate after a permanent separation and
previously had
24-months of State service (no permanent break in service during the
24-months), may enroll in the DeltaPremier or PPO Plan at the time of
hire.
All eligible newly hired represented employees in Bargaining Units 2,
7, 8, 16, 17, 18, 19, and excluded employees (non-represented) may elect
the DeltaPremier or PPO Plan, at the time of hire and are not
restricted to State-sponsored prepaid plans.
It shall be the responsibility of the Personnel Office to notify all impacted newly hired represented employees of this restriction. Personnel Offices should provide the 24-month restriction end date to represented employees effected by this restriction. Personnel offices should also inform employees affected by this restriction that the employee is required to initiate a STD. 692 to enroll or change their dental coverage to a Delta Dental Plan, within 60 days from the date they complete the required 24 months of State service. Use Permitting Event Code 08 on the STD. 692 to process the change. Employees that do not take action to either enroll or change dental plans within the 60 day time period, may elect to enroll/change enrollment during the next scheduled dental open enrollment period.
Bargaining Units 5 and 6
All newly hired represented employees in Bargaining Unit 5 must elect their dental coverage from one of the State-sponsored prepaid dental plans. After completing a
24-month restriction period, Unit 5 employees may enroll or change to the CAHP union-sponsored indemnity plan, Blue Cross, as long as they are members of CAHP. Use Permitting Event Code 08 on the STD. 692 to process the enrollment or change.
All newly hired represented employees in Bargaining Unit 6 must enroll and maintain coverage in the Union-sponsored prepaid plan, Western Dental, for a period of 12 consecutive months from the effective date of their enrollment. After completing the
12-month restriction period, Unit 6 employees may change to the CCPOA Union-sponsored indemnity plan, Fee-For-Service Dental Plan. Use Permitting Event Code 08 on the STD. 692 to process the change. Those employees that chose not to enroll in the Western Dental Plan will not be allowed to enroll in the Fee-For-Service Dental Plan until they have been enrolled for 12 consecutive months in Western Dental.
Exceptions to the 24 Month Restriction Periods
The following provides information on instances when eligible represented employees will be exempt from the 24-month restriction and allowed to enroll in Delta Dental at the time of hire:
- Newly Hired Employees with a LT or TAU Appointment
Employees who are hired to State service with a LT or TAU appointment may use time served in those classes (no permanent break in service) to count towards meeting the 24-month restriction period and enroll at the time of hire if they have the necessary months of state service. However, individuals hired as a Student Assistant, Temporary or Seasonal employee (with exception of Seasonal Firefighters and Lifeguards), may not count time served in those classes towards meeting the 24-month restriction period.
- Employees Hired to State Service with Current Delta Dental Coverage
Newly hired eligible employees who have their own current State-sponsored dental coverage with Delta Dental at the time of hire, will be allowed to enroll in Delta Dental and continue their coverage if they meet any of the following conditions:
- CalPERS retiree, enrolled in Delta Dental, who is reinstating from retirement status and eligible as an active employee for State dental coverage.
- New hire or transfer (no break in service) from another State
government agency or the University of California system (excluding
coverages under city, county, federal, private/public sector, or as a
dependent on their parent/spouse state-sponsored plan).
- Prior State employees, who continued and maintained their State Delta Dental coverage based on their COBRA eligibility (COBRA coverage must be current at the time of hire).
- Prepaid Dental Plan Provider (Dentist) Not Available Within 50 Miles
Newly hired eligible employees who do not have a prepaid dental plan provider available within 50 miles of their residence may enroll in Delta Dental at the time of hire. The Personnel Office must send a written memo along with a completed STD. 692 to the SCO Benefits Unit. The memo must state that none of the available prepaid plans have a dentist within the employee's service area. Upon verification of this information by the appointing authority, forward the document to SCO for processing.
Note: For CCPOA members the distance restriction is 35 miles.
- Prior State Employees that Worked For 24 Months
All eligible newly hired or current employees that were previously a State employee for 24 months without a permanent break in state service will be allowed to enroll or change to Delta Dental with a current effective date.
Important Note: For employees participating in Flex/COBEN Cash, the choice made by these employees for dental insurance (enroll in a State-sponsored plan or elect cash in lieu of their dental benefit) will continue to be a three-year commitment, subject to certain limited exceptions.
The STD. 692 for prior State employees being enrolled in Delta Dental under a permitting event does not require DPA approval and should be sent to SCO for processing.
- Prior State Employees Hired With Mandatory Reinstatement
Eligible employees who have mandatory reinstatement rights to State service may enroll into Delta Dental. The Personnel Office must send a written memo along with a completed STD. 692 to DPA, Benefits Division. The memo must indicate that the employee has been mandatorily reinstated. Upon verification of this information, DPA will approve the enrollment to Delta Dental and forward the document to SCO for processing.
- Employees Hired After Layoff
Newly hired eligible employees who were terminated due to layoff from a State-government agency and are then re-hired within 36 months will have one of the following conditions apply:
- If the employee was enrolled in Delta Dental at the time of layoff, he/she will be allowed to reenroll in Delta Dental and will not be required to complete a 24-month restriction period.
- If the employee had served a portion of the 24-month period prior to layoff, that time may be included with time served upon rehire to meet the 24-month requirement for enrollment into Delta Dental.
For enrollment of the rehired employee, the Personnel Office must send a completed STD. 692 to SCO, and in the remarks section, indicate that the employee is being reinstated after layoff. The Personnel Office should use Permitting Event Code 01a when completing the STD 692. The Personnel Office is charged with the responsibility to certify that the conditions stated in this section are met.
- Permanent-Intermittent (PI) Employees
Eligible PI employees who have met the required 24 month restriction period may change to Delta Dental during their current PI Control Period. Those PI employees who are not currently enrolled in a prepaid plan after completion of the 24-month restriction period may only elect to enroll in Delta Dental after completion of their current PI Control Period.
Enrollment Processing Upon Completion of 12/24 Month Restriction Periods
The Personnel Office should use Permitting Event Code 08 when completing the STD. 692. This code will be used to enroll in or change enrollment after completion of the 12 or 24-month restriction periods. Refer to the Permitting Event Code Chart (Attachment C) for processing cut-off date.