State of California

  M E M O R A N D U M

  REFERENCE CODE:
  2004-002

  DATE:
  January 16, 2004

  TO:
  Personnel Officers
  Personnel Transactions Supervisors
  Personnel Transactions Staff

  FROM:
  Department of Personnel Administration
  Benefits Division

  SUBJECT:
  2004 Delta Preferred Option Dental Premium Change

  CONTACT:
  Bryan Bruno, Benefits Program Analyst
  (916) 445-9841, CALNET 485-9841
  FAX: (916) 322-3769
  Email: BryanBruno@dpa.ca.gov


  This memo is to notify you of a change in the State Share 
  and Employee Share of the 2004 Delta Preferred Option (DPO)
  Premium for Party Code 1 (employee only).  There are no 
  changes in the premiums for the DPO Party Code 2 (employee 
  plus one dependent) or the DPO Party Code 3 (employee plus 
  two or more dependents).
  
  In the December 2003 pay period, for dental coverage 
  effective January 1, 2004, the following premium was paid 
  for employees enrolled in the DPO with a Party Code 1:
  
                 Total Premium     State Share    Employee 
  Share
  
  Party Code 1        $39.89         $29.92           $9.97
  
  In order to comply with the provisions of the 2004 
  bargaining agreements, effective February 1, 2004 (January 
  2004 pay period), the DPO Party Code 1 premium will be 
  adjusted as follows:
  
                 Total Premium     State Share    Employee 
  Share
  
  Party Code 1        $39.89         $30.70           $9.19
  
  An adjustment for the December 2003 pay period will also be 
  made in the January 2003 pay period.
  
  
  
  This adjustment impacts employees in bargaining units 1, 3, 
  4, 5, 9, 10, 11, 12, 13, 14, 15, 20, and 21 who are 
  enrolled in the DPO with Party Code 1 coverage.  Employees 
  enrolled in Consolidated Benefits (CoBen) are not impacted.  
  Excluded employees, and employees in bargaining units 2, 7, 
  8, 16, 17, 18, and 19, are in CoBen.  In addition, there 
  are no changes for employees in Bargaining Unit 6 as they 
  receive a composite rate.
  
  Attached for your use is a revised rate sheet for the 
  dental premiums showing the revised employee share of the 
  DPO Party Code 1 premium.  This attachment replaces 
  Attachment IV in PML 2003-037 dated September 26, 2003.
  
  If you have any questions regarding this information, 
  please contact Bryan Bruno, Benefits Program Analyst, at 
  (916) 445-9841, or CALNET 485-9841.
  
  Sincerely,
  
  
  
  Debbie Endsley, Acting Chief 
  Benefits Division
  
  
  
  Attachments will be distributed via mail.