State of California M E M O R A N D U M REFERENCE CODE: PML 95-039 DATE: August 15, 1995 TO: Personnel Officers Personnel Transactions Supervisors Personnel Transactions Staff FROM: Department of Personnel Administration Benefits and Training Division SUBJECT: 1995 Dental Open Enrollment Period CONTACT: William Page, Dental Program Coordinator (916) 324-0525 or CALNET 454-0525 Office Vision: DPA (WHPAGE) INTERNET: WHPAGE@SMTP.DPA.CA.GOV The following information regarding the 1995 Dental Open Enrollment Period should be communicated to all employees as soon as possible. DENTAL PROGRAM INFORMATION The Department of Personnel Administration (DPA) has current contracts with Delta Dental, DentiCare of California, Inc., Private Medical Care, Inc. (PMI), and Safeguard Health Plan to provide dental insurance for: (1) retirees/annuitants; (2) excluded employees; and (3) represented employees in Bargaining Units 1 through 21, with the exception of Units 6 and 13, who have their dental insurance provided through their respective Union- sponsored trusts. Unit 5 employees have their own indemnity dental plan, but may enroll in the State- sponsored prepaid plans. State Retirees/Annuitants will receive dental open enrollment information during August from DPA at their home address. DENTAL OPEN ENROLLMENT Open enrollment for dental benefits will be held from September 1, 1995 through September 30, 1995. All actions taken during this open enrollment period will become effective January 1, 1996. Eligible employees may enroll in a dental plan, change dental plans, and add/delete dependents during this period. Employees wishing to enroll or make a change to their current dental coverage must sign/date a Dental Enrollment Authorization (STD. 692) no later than September 30, 1995. No action is necessary for those employees who are currently enrolled and do not wish to make any changes in their dental coverage. DOCUMENTATION Please use the following information when completing the dental open enrollment documents: PERMITTING EVENT CODES: 03 - New Enrollment 15 - Add/Delete Dependent(s)- may use one form 28 - Change of Plan 29 - Change of Plan and Add/Delete Dependent(s)-may use one form PERMITTING EVENT DATE: 9/1/95 CUT-OFF/EFFECTIVE DATES All documents submitted to the State Controller's Office (SCO) during the open enrollment period must be signed/dated by the Personnel office and the employee no later than September 30, 1995. The effective date for all actions will be January 1, 1996. All documents should be received at SCO no later than November 13, 1995. All documents returned to the Personnel office by SCO for needed corrections must be corrected and received at SCO no later than December 11, 1995. Current FlexElect participants and those electing to enroll in FlexElect during the September FlexElect Open Enrollment Period may make changes to their dental coverage. These changes will also be effective January 1, 1996. Any dental form (STD.692) that is submitted as part of a FlexElect enrollment or change must be submitted to SCO according to the FlexElect instructions. Please refer to the FlexElect Procedures Manual. DELTA DENTAL RESTRICTION Represented employees who are restricted to a State- sponsored prepaid plan until they have completed 24 months of State service will not be allowed to enroll or change to the indemnity, Delta Dental Plan during this open enrollment period. At the end of their respective 24 month period, these employees will have 60 days to elect or change to the Delta Dental Plan, should they wish to do so. BLUE CROSS RESTRICTION Bargaining Unit 6 (R06) employees who are restricted to the Union-sponsored prepaid Dental Net Plan until they have completed 12 months of State service will not be allowed to change to the indemnity, Blue Cross Plan during this open enrollment period. At end of their respective 12 month period, these employees will have 60 days to change to the Blue Cross Dental Plan, should they wish to do so. DENTAL PLAN DESCRIPTIONS,CLAIM FORMS,EVIDENCE OF COVERAGE (EOC) BOOKLETS,PROVIDER OFFICE LISTS AND MEMBERSHIP CARDS, A brief description of the State-sponsored dental plans and a comparison chart is provided on Attachments I and II. For more detailed information, consult each carrier's EOC booklet. For more information regarding Union- sponsored plans, Units 5, 6, and 13 employees should be advised to contact their Exclusive Representative. Claim forms are not required by DentiCare, PMI, or Safeguard. Delta Dental claim forms are available at most dental offices or Delta Dental. Although the departmental Personnel Office should maintain a small supply of EOC booklets and provider lists, employees should contact the carriers directly for additional booklets and/or information. Membership cards (if appropriate) will be mailed by the carrier(s) after open enrollment. DENTAL PREMIUM RATES - EMPLOYEE COPAYMENT Attachment III reflects the total premiums and employee copay amounts for represented and excluded employees enrolled in the State-sponsored dental plans, and carrier information. There will be no increase for 1996 in the amount employees pay each month for their Delta Dental coverage. The State contribution for the prepaid plans continues to be 100 percent paid with no premium cost to those employees enrolled in a prepaid plan. COBRA RATES COBRA rates for 1996 are provided on Attachment IV. Please note that there has been an increase in the 1996 COBRA rates for the prepaid plans. INDEMNITY DENTAL PLAN BID-DENTAL PROCEDURES MANUAL DPA has recently completed the Indemnity Dental Plan Bid evaluation. The Delta Dental Plan has been selected as the successful bidder. The new Delta Dental contract will begin January 1, 1996. The updated Dental Procedures Manual is scheduled to be completed and mailed to departments in late 1995. DEPARTMENTS' ROLE IN THE OPEN ENROLLMENT PROCESS Your assistance in making this open enrollment a success will be appreciated. Personnel offices are being asked to inform all employees; have informational packages available; review all documents before submitting them to SCO; and be aware of thecut-off dates. All employees electing to enroll or change their dental enrollment should be advised to check their December "Statement of Earnings and Deductions" to ensure correct dental plan coverage. Please instruct your employees "not to use their dental coverage until they see the appropriate deduction on their earnings statement. If they do, they will be liable for any expenses incurred for dental services which are performed prior to their actual effective date". Employees should be directed to contact their departmental Personnel Office if they have any questions regarding this open enrollment period. Personnel Office staff requiring assistance or clarification of the information contained in this memo should call William Page, Dental Program Coordinator, at (916) 324-0525 or CalNet 454-0525. Patricia Pavone, Chief Benefits and Training Division Attachments cc:SCO, Del Delgado/Linda Edwards/Laverne Krebs PERS, Mark Quillici STRS CAHP DENTAL TRUST CCPOA DENTAL TRUST DEPARTMENT OF THE MILITARY FAIRS AND EXPOSITIONS LOS ANGELES COUNTY SUPERIOR COURT JUDGES ATTACHMENTS WILL BE MAILED WITH ORIGINAL COPY.