• 501. General Information
• 502. Current State-Sponsored Dental Plans
• 503. Responsibilities
• 504. Dental Plan Deduction Codes/Premiums
• 505. Employee Eligibility
• 506. State Dental Plan Restriction for Newly Hired State Employees
• 507. CCPOA Benefit Trust Fund Dental Enrollment
• 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

506. 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 Dental PPO. 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.

Dental Premier or Delta Dental PPO. 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 Unit 5

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.

Exceptions to the 24-Month Restriction Period

The following provides information on instances when eligible employees will be exempt from the 24-month restriction and allowed to enroll in Delta Dental at the time of hire:

1. 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.

2. 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:

   1. CalPERS retiree, enrolled in Delta Dental, who is reinstating from retirement status and eligible as an active employee for State dental coverage.

   2. New hire or transfer (no break in service) from another State government agency or California State University (CSU) or University of California (UC) systems (if prior coverage was under city, county, federal, private/public sector, or as a dependent on their parent/spouse state-sponsored plan, then the employee is not eligible for this exception).

      Important Note: For these exceptions, departments must confirm current Delta Dental Plan coverage. Indicate the specific exception in the remarks section on the STD. 692: Prior Delta Dental coverage with “Another State Government Agency” or “CSU” or “UC”.

   3. Prior State employees, who continued and maintained their State Delta Dental coverage through COBRA (COBRA coverage must be current at the time of hire).

3. Excluded Employees

   All eligible newly hired 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.

4. Represented Employees in Consolidated Benefits (CoBen)

   All eligible newly hired represented employees in Bargaining Units 2, 7, 8, 16, 17, 18, and 19, may elect the DeltaPremier or PPO Plan, at the time of hire and are not restricted to State-sponsored prepaid plans.

5. 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.

6. 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.

7. 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.

8. 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:

   1. 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.

   2. If the employee had served a portion of the 24-month period prior to layoff, then 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.

9. 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.