Benefits - Benefits Administration Manual

Department of Personnel Administration

Benefits Administration Manual

Section 500

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Dental Program

512. Effective Dates

There are two types of effective date rules that are applied to all dental enrollment transactions: Mandatory and Standard. The type of permitting event determines which effective date rule should be applied. Events, such as loss of coverage, deletion of dependents due to death or marriage, etc., would normally necessitate immediate action and therefore the mandatory effective date rule would apply. Those events that do not require immediate action would come under the standard effective date rule, i.e., initial enrollment, deletion of dependent at age 18, etc.

Attachment C, Permitting Event Code Chart, lists all of the various dental permitting event codes as well as the respective effective date rule that should be applied.

Mandatory Effective Date Rule

First of the month following the permitting event that allows the action to occur.

Example:

Event occurs any time during the month the effective date will be the first day of the month immediately following the event. Employee's date of divorce is 10/23. The effective date is 11/1.

Standard Effective Date Rule

First of the month after the STD. 692 is completed and received by the employing department.

Example (1)	Employee hired 07/14/08 and submits STD. 692 on 08/11/08. The effective date is 09/01/08.
Example (2)	Spouse moves out of household 03/25/08 and employee submits STD. 692 on 04/02/08. The effective date is 05/01/08.

Note:

STD. 692 forms which are submitted to SCO and must be returned to the employing office due to incomplete or incorrect information will maintain the original effective date. Personnel Office staff needs to be aware, however, that document processing problems will result in a delay in eligibility information being sent to the dental carriers. Employees should be advised accordingly.

Retroactivity/Emergency Plan Change

Except when approved by DPA, retroactivity/emergency plan changes will not be allowed. Employees must be advised not to use their dental plan prior to the effective date shown on the STD. 692 enrollment document, signed by the authorized agency representative or date approved by DPA. A brief memo along with the completed STD. 692 should be submitted to DPA for review. The DPA may request other types of documentation to support an appeal.

Revolving Fund Checks

Since deductions are not taken from revolving fund checks, employees who receive a revolving fund salary check will not have dental eligibility established with their respective dental carrier until a regular salary warrant is issued by SCO. Personnel Office staff should contact DPA in instances when an employee receiving a revolving fund check requires emergency dental treatment either for self or an eligible dependent so DPA can assist in verifying eligibility with the employee's dental carrier.