1. Dental carriers do not send a monthly bill to an employee who elects to pay premiums directly while he/she is off pay status. Therefore, it is the responsibility of each employee to ensure premium payments are paid timely. Direct pay is normally limited to 12 months. However, in the event of an approved extension to the leave of absence, the carrier will accept direct payments beyond the normal one-year period.

2. Payments must be paid in advance and cover a minimum period of three months or the length of the absence whichever is less. The employee's check/money order for the first three months must be attached to the newly completed STD. 696 and sent to the carrier.

3. The dental carrier must receive the initial payment by the first day of the month following the first full month the employee is off pay status. Subsequent installments and/or final payment are due to the dental carrier by the first of each subsequent three-month period. STD. 696 forms received by the dental carrier without the required payment attached will be returned to the employee. Failure to pay the required payment in a timely manner will result in the employee's dental coverage being cancelled.

4. In the event an employee returns to pay status prior to the end of his/her approved leave of absence, it will be the employee's responsibility to contact his/her dental carrier to request a refund of any direct premium overpayments paid.

An employee who has a permitting event occur while on non-pay status may make changes to his/her dental enrollment as indicated below:

1. An employee is responsible for contacting his/her Personnel Office and completing a new STD. 692 reflecting the enrollment change. The Personnel Office must forward the document to SCO for processing.

2. If an employee is on direct pay and the change results in a change of premium, a new STD. 696 must also be completed.

3. If an employee deletes any dependent prior to or during the leave, the dependent may not be re-enrolled until the next open enrollment period.

Return to Pay Status

Upon return to pay status (if an employee is still enrolled), the State premium contributions will commence with the first pay warrant issued by SCO.

The Personnel Office should check the employee's pay warrant to verify that the dental plan name is reflected. If the dental deduction is not shown, contact SCO to establish.

Dental Benefits for Exempt Employees Separating from State Service

For exempt employees who are separating from State service, and have not reached retirement age, but desire to continue their dental benefits until they reach minimum retirement age, the conditions listed below will be applicable.

Conditions of Eligibility

Exempt employees who have at least ten (10) years of State service which includes at least two (2) years of credited service while an exempt employee, who permanently separate from State service on or after January 1, 1988, and at the time of separation have more than 10 years before they would attain their minimum age for service retirement from State service, may elect to continue or not continue their dental benefits until their date of retirement.

For these employees, the following two options are available at the time of separation:

1. An exempt employee may choose not to continue his/her dental benefits at the time of separation. However, the separated exempt employee will be eligible to enroll in a dental plan at the time of his/her future date of retirement.

2. An exempt employee may elect to continue his/her dental benefits at the time of separation. The enrollment must be made within sixty (60) days from their date of permanent separation. The premium rate is 102 percent (%) of the current State rate. While this rate is the same as the COBRA rate, continuation of coverage in this instance is not part of COBRA.

Dental Plan Enrollment Form and Premium Payment

Should an exempt employee elect to continue dental benefits at the time of separation, the following information on enrollment procedures is being provided.

Indemnity and PPO Plans - Delta Dental

For enrollments in Delta Dental (Delta), exempt employees should complete the "Delta 602A" form. The following statement should be written across the top of each form, "Based on Section 22816.7 of the Government Code". This form can be obtained from Delta Dental's Marketing Administration by calling (415) 972-8300 (ask for Account Services). The enrollment form and initial premium payment should be sent to the California Public Employees' Retirement System (CalPERS) for verification of eligibility. CalPERS will forward the enrollment form and initial payment to Delta for processing. The premiums must be paid on a quarterly schedule. After the initial enrollment, subsequent premiums are sent directly to Delta and due by the first day of the month that the quarter begins (January, April, July and October). Non-payment for two (2) consecutive quarters will automatically disqualify the enrollee from this program. To ensure that the quarterly premiums are credited properly, enrollees should write their social security number and group number 9949-8601 (Delta Premier) or 9946-8601 (PPO) on their payment check.

Prepaid Plans - DeltaCare USA and SafeGuard

For enrollments in DeltaCare USA and SafeGuard, exempt employees should complete the "Dental Plan Direct Payment Authorization (STD. 696)". The following statement should be written across the top of each form, "Based on Section 22816.7 of the Government Code". The enrollment form and the initial payment should be sent to the Department of Personnel Administration (DPA) to the attention of the Dental Coordinator, for verification of eligibility. DPA will forward the enrollment form and initial payment to the dental carrier for processing.

The premiums will be paid on a monthly schedule. After the initial enrollment, subsequent premiums are sent directly to the carrier and due by the first day of each month (January, February, March, etc.). Non-payment for two (2) consecutive months will automatically disqualify the enrollee from this program. To ensure that the monthly premiums are credited properly, enrollees should write their social security numbers and "state exempt employee" on their payment check.

Reference:  Government Code Section 22816.7