DPA - Benefits - Open Enrollment 2007 - Retirees and Annuitants - Dental Benefits

Coverage for a retiring employee changes under the following conditions:

If you are enrolled in DeltaCare or SafeG uard and move into an area where a prepaid plan is not available you will be allowed to change your dental enrollment to Delta Dental.
If you are enrolled in SafeGuard you will automatically receive the Enhanced level of coverage when the dental enrollment form is processed by CalPERS.
If you were an excluded employee who is enrolled in the Delta Dental Premier dental plan and receiving the Enhanced level of coverage you will automatically be moved to the Basic level of coverage upon retirement when the dental enrollment form is processed by CalPERS.

Your spouse or domestic partner is eligible to continue dental benefits.
Your natural, adopted and economically dependent children under the age of 23 or medically disabled eligible dependent children may be continued on your retired dental benefits.

There are MANDATORY changes that must be made and there are VOLUNTARY changes that may be made.

Mandatory changes are: divorce or termination of domestic partnership, death of a dependent, dependent child marries or reaches age 23, dependent goes into the military or becomes a State employee and enrolls as an employee in a State-sponsored dental plan.
Voluntary changes are: adding a newly acquired spouse, certified domestic partner or dependent child, adding dependents that have lost coverage, adding a dependent due to change of custody or deleting dependents who obtain other group coverage. You can change plans during an Annual Open Enrollment Period, if you are in a prepaid plan and move out of California or if your dental plan does not have a dental provider within a 50 mile radius of your residence. Note: Voluntary changes must be initiated by the retiree within 60 days from the date of the event.
Administrative changes initiated by CalPERS are: the deletion of dependents that reach age 23.

Your dependents, as survivors are entitled to continue dental coverage if they will also be receiving a continuing monthly benefit from CalPERS.
Questions regarding eligibility as a survivor should be addressed to CalPERS, Post Retirement Division at 1-888-225-7377.

Once enrolled, retirees may cancel enrollment at any time by notifying CalPERS in writing.
Once cancelled, retirees may not re-enroll in a dental plan until the next scheduled open enrollment period.

CalPERS, Health Benefit Services Division
Post Office Box 942714
Sacramento, California 94229-2714
Phone: 1-888-225-7377

For information about your dental plan you may request an Evidence of Coverage (EOC) Booklet from the carrier.

DeltaCare USA (formerly named Private Medical-Care, Inc. [PMI]) 1-800-422-4234
SafeGuard Health Plans 1-800-880-1800
Delta Premier 1-800-225-3368
Delta PPO 1-800-225-3368

Updated September 24, 2007 at 2:00 PM.

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