• 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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516. 120-Day Survivor Death Benefit for Continuation of Benefits

Under the 120-day death benefit, departments are required to continue to pay the employer contributions for a covered employee's spouse, domestic partner and/or other eligible family members for up to 120 days following an employee's death. The 120-day period is to provide the family a grace period while the California Public Employees' Retirement System (CalPERS) determines if the spouse or other family members are eligible for a survivor's benefit.

In implementing this benefit, departments will use the process used for an employee on an unpaid leave of absence (STD. 696). Under this process, the deceased employee's department will pay four months of both the employer and employee contributions directly to the dental carriers.

An eligible spouse and/or other eligible dependent(s) who is determined to be an eligible survivor and receives a continuing allowance from CalPERS may continue dental coverage as annuitants.

If CalPERS determines that the spouse and/or other eligible family member(s) is not eligible for a continuing allowance, then the department should notify the spouse and/or other eligible family member(s) of COBRA eligibility within sixty days from the date CalPERS makes this determination. Upon notice of COBRA eligibility by the department, it is the responsibility of the spouse or other eligible family member(s) to pay monthly premiums directly to the carrier(s) in the manner prescribed in the COBRA notice.

Authority:

Collective bargaining agreements (all twenty-one bargaining units) Legislation enacted - AB 1639, Chapter 926, 1999

Reference:

1. Personnel Management Liaison Memorandum (PML) 99-066
2. DPA Personnel Transaction Supervisors and Personnel Transaction Staff Memorandum dated August 7, 2001.