State of California M E M O R A N D U M To: PERSONNEL MANAGEMENT LIAISONS Date: January 10, 1992 Reference Code: 92-09 THIS MEMORANDUM SHOULD BE DISTRIBUTED TO: ALL PERSONNEL OFFICERS, PERSONNEL TRANSACTIONS SUPERVISORS AND PERSONNEL TRANSACTIONS STAFF From: Department of Personnel Administration Subject: SPECIAL DENTAL OPEN ENROLLMENT PERIOD - EXCLUDED EMPLOYEES ONLY In light of the fact that all excluded employees are now required to pay an employee premium for their dental coverage in the Delta Dental Enhanced Plan, a special dental open enrollment period will be held during the month of February. During this period, excluded employees who are enrolled in Delta Dental will be allowed to change from Delta to one of the available State funded prepaid plans; PMI, DentiCare, or CDHP. This is the only change that will be allowed as part of this special enrollment process. As always, employees can continue to voluntarily cancel their coverage or add/delete dependents based on the normal permitting events which are currently in place. ENROLLMENT PROCESS Each employee wishing to make a change will need to complete a STD-692, Dental Enrollment Form during the month of February. The effective date of the change will be dependent on when a CORRECTLY completed form is received by the State Controller's Office (SCO). Forms received at SCO Effective Date February 14, 1992 March 1, 1992 March 10, 1992 April 1, 1992 NOTE: SCO has agreed to process these special open enrollment documents past the normal February 10 cutoff. Accordingly, the February 14, 1992, date applies only to this process and any other type of documents submitted to SCO will need to meet the normal cutoff. Permitting Event Code: 28 Permitting Event Date: 2/1/92 PML 92-09 January 10, 1992 Page 2 March 10, 1992, will be the last date special open enrollment documents will be accepted by SCO. Documents received after that date will be returned to the Personnel Office and the employee will be required to wait until the annual dental open enrollment period. FLEX PARTICIPANTS As you are all aware, employees enrolled in the traditional FlexElect Program are not normally allowed to change their health and/or dental plans during the Flex Plan Year. Due to the fact employees were not aware during the Flex open enrollment last September that an employee copay would be implemented for Delta Dental, a decision has been made to allow Flex participants to change from Delta to a prepaid plan during this special open enrollment period only. If a Flex participant wishes to change dental plans a STD-701, FlexElect Enrollment Form will need to be completed AND submitted along with the required STD-692. Please remember that in addition to indicating the new dental code information, all other items on the Flex form must be completed exactly like the employee's original Flex enrollment document. The reason for this is that SCO has to reenter all of the Flex election information, not just that information which is changing. Your cooperation in notifying your excluded employees of this special open enrollment period will be appreciated. While we do not anticipate that there will be a large number of employees wishing to change their Delta coverage, should you have questions regarding this process please direct them to Nick Villa at (916) 324-9486 or ATSS 454-9486. Questions relating to Flex participants should be directed to Janice Yates at (916) 324-0535 or ATSS 454-0535. Thank you for your assistance. Patricia Pavone, Chief Benefits and Training Division