Dental Benefits - CalHR

Dental Benefits

You and your dependents may be eligible for State-sponsored dental insurance, available from one of several dental plans. Eligible employees may enroll in a dental plan within the first 60 days of employment or eligibility, or during the annual open enrollment period. Changes in coverage are also permitted during open enrollment.

 

Your collective bargaining designation determines which plans are available to you. The State pays all or part of your premium, depending on the plan you select and the number of dependents you wish to cover.

 

If you are in Bargaining Units 1, 3, 4, 5, 6, 9, 10, 11, 12, 13, 14, 15, 20, and 21 and have dental coverage through another source, such as your spouse, you may choose to receive cash in lieu of the State's dental benefit. This additional cash is treated as taxable income. You may enroll in this "cash option" when you are hired, during the annual open enrollment, or when you experience a permitting event which makes you newly eligible.  The cash option is also available in lieu of health benefits.

 

If you are in Bargaining Units 2, 7, 8, 16, 17, 18, 19, or an excluded employee, you can receive cash in lieu of health benefits, or in lieu of health and dental combined, but you cannot receive cash in lieu of just dental benefits.

 

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2013 Dental Open Enrollment for active state employees

The 2013 Open Enrollment period for Dental is September 16th through October 11th, 2013.
During Open Enrollment, eligible employees may:
 
  • enroll in a dental plan
  • change dental plans
  • add or delete dependents

 

Open enrollment forms must be signed and submitted to your Personnel Office no later than October 11, 2013.  All open enrollment changes will be effective January 1, 2014.  If you don't want to make any changes to your Dental coverage, you don't need to do anything. More Open Enrollment Information are available below:

 

What's New for 2014

Effective January 1, 2014, the State’s Premier plan names are being changed to the Delta Dental PPO plus Premier plans. The current Delta Dental Premier Basic plan will change to the Delta Dental PPO plus Premier Basic plan. The current Delta Dental Premier Enhanced plan will change to Delta Dental PPO plus Premier Enhanced plan. Member benefits for the Delta Dental Premier Basic and Enhanced plans will NOT change.

Important Reminders

  • One-time enrollment period reminder for employees in same-sex marriages:


Consistent with the June 26, 2013, United States Supreme Court decisions, same-sex marriages are now legally recognized in California. Departments will now accept same-sex marriage certificates for benefit eligibility and enrollment without regard to gender.


Employees married to a same-sex spouse prior to or following the US Supreme Court decisions on June 26th, 2013, or who were in a Domestic Partnership but married following the Federal Court decision, and wish to add their spouse and/or their spouse’s dependent children, currently have the opportunity to enroll their spouse and their spouse’s eligible dependent children onto their dental and/or vision plan(s).

 

A one-time enrollment period is now in effect through December 31, 2013. Enrollment forms must be received in your personnel office by December 31, 2013, to qualify for the one-time enrollment period. After December 31, 2013, enrollments will be subject to the regular enrollment rules around addition of spouses and dependents.


If already in a same-sex marriage prior to the Court’s decisions and have you spouse enrolled on your benefits, the State was obligated to report those benefits as income and withhold additional Federal income taxes, Social Security and Medicare from your paycheck. If this applies to you, you must notify your personnel office and have them assist you to stop the additional Federal tax withholding. Otherwise, your tax status will remain “as is” and the additional Federal income taxes, Social Security and Medicare will continue to be withheld.  Please contact your personnel office for further assistance.


  • Your children are eligible for dependent health and dental coverage up to age 26.
  • Dependent children employed by the State and eligible for State-sponsored dental plans are also eligible to enroll in their parent's State sponsored dental plan.
  • State employees who are dependents on their parents benefits, whether or not the parent is a State employee, are eligible to receive the cash in lieu of dental coverage.

 

Eligibility

  • The State determines employees' eligibility to enroll in dental plans by appointment, time base, and tenure - In most cases, all permanent employees who work the equivalent of half-time or more are eligible
  • Permanent-Intermittent employees who work a minimum of 480 hours during each six month qualifying control period ending June 30th and December 31st are eligible
  • Employees whose positions are classified as Limited-Term or Temporary Authorized appointments, who are appointed to a position of six months or more and at a time base of half time or more are eligible
  • Unit 8 Seasonal Firefighters and Unit 7 Lifeguard II's are eligible to enroll in the State-sponsored Dental Program during their period of employment in accordance with their respective Memorandums of Understanding (MOUs)  
Contact your HR Office if you have questions regarding your eligibility for enrollment in the State's Dental Program.
 

Dependent Eligibility

You may enroll your legal spouse, domestic partner, and dependent children up to age 26, when you experience a family status change, or during the annual open enrollment period.
 

Dependent children include:

  • A natural child
  • Stepchild
  • Legally adopted child
  • A dependent child living with you in a parent/child relationship
 
If you elect not to enroll a newborn within 60 days from birth, you can enroll the child within 60 days of each birthday until the age of six or during a dental open enrollment period.
 
It's your responsibility to inform your HR Office of changes with your dependents, including divorces, legal separations*, dissolution of domestic partnership, termination of parent-child relationship with dependent children, and when your dependent children who are not disabled** turn age 26. These are events where you're required to inform your HR Office so they can assist you in removing the ineligible dependents from your dental plan if enrolled.
 
*For legal separations, a deletion of the spouse cannot be done in anticipation of a pending or active divorce action or pending final divorce settlement. When the divorce is finalized, you're required to inform your HR Office of the finalization and provide a copy of the final divorce decree.
**For a disabled child to remain on your dental plan past age 26, you must have a disability certification letter on file with your human resources office, or inform your human resources office of pending disability certification prior to your child turning age 26.
 

Enrollment

  • You have 60 days from your date of hire or the date you became eligible to enroll in a dental plan.
  • If eligible, you may also enroll during the annual open enrollment period.
  • Except noted below, newly hired represented employees may select only a prepaid plan until they have completed 24 months of employment without a permanent break during a 24 month qualifying period - At the end of the 24 month period they will have 60 days to elect or change to the indemnity plan.
  • Employees in Bargaining Units 2, 7, 8, 16, 17, 18, and 19 are not subject to the 24 month restriction.
 

Open Enrollment

  • Open enrollment is a time set aside each year when eligible employees can enroll, change plans, or add/delete family members.
  • The open enrollment period for the State Dental Program is normally held each year from September through mid-October.
  • Actions made during open enrollment are effective January 1st of the following year
 .
HR Offices are reminded to review their employees' enrollment and remove ineligible dependents, including dependent children who are not disabled and have reached age 26.
 

Dental Plans

There are three types of dental plans available, prepaid, PPO, and indemnity:
 

Prepaid Plans:

DeltaCare USA, SafeGuard, Premier Access, and Western Dental

  • A prepaid plan requires you and your eligible dependents to use a dentist from a specific list of dentists who are located in California and who contract with your selected prepaid carrier.
  • Dentists receive a flat fee for each member assigned to their offices.
  • Most basic services are covered at no cost.
  • The monthly premium is fully paid by the State - No premium is deducted from your monthly pay warrant.
 
For more information or a list of member dentists, contact the plans at:
DeltaCare USA
1-800-422-4234
 
Premier Access
1-888.534-DHMO (1-888-534-3466)
 
SafeGuard
1-800-880-1800
 
Western Dental
1-866-859-7525

Preferred Provider Option:

Delta Dental Preferred Provider Option (PPO) - Group #9946

  • The State-sponsored Delta Dental Preferred Provider Option (PPO) plan provides services through its network of participating dentists and allows you to see any dentist of your choice world-wide and still be covered.
  • Your present dentist may be a PPO member of Delta Dental; however, not all Delta Dentists are members of the PPO network - If you receive services outside of the PPO network, your share of the dentist's fees will be substantially higher - You may contact Delta Dental to ensure there's a PPO provider available in your service area.
  • Your cost for services .is based on a fee-for-service agreement between Delta and the PPO provider - The plan limits paid coverage for each specific type of dental treatment - Members pay any remaining balance due based on the type of dental treatment they receive.
  • The amount of your monthly premium copayment is deducted from your monthly pay warrant according to the number of enrolled dependents.
 
For more information, contact:
Delta Dental
1-800-225-3368

Indemnity Option:

Delta Dental PPO plus Premier - Group #9949

  • An indemnity plan allows enrollees to select a dentist of their choice throughout the United States and worldwide without using a provider network.
  • The plan limits the amount of paid coverage for each specific type of dental treatment - Members pay any remaining balance due based on the type of dental treatment they receive.
  • The amount of your monthly premium copayment is deducted from your monthly pay warrant according to the number of enrolled dependents.

 

For more information, contact:
Delta Dental
1-800-225-3368
 

State-Sponsored Dental Plan Premiums

The premiums shown below are effective January 1, 2014. They don't include the administrative fee of $1.69 per month.
For employees under CoBen, the total premium is deducted from the CoBen benefit allowance.
 

Delta Dental PPO plus Premier Basic Plan for Represented Employees

  • Employee only: The total premium is $48.48 which includes a State share of $36.36 and an employee share of $12.12
  • Employee plus one dependent: The total premium is $85.13 which includes a State share of $63.85 and an employee share of $21.28
  • Employee plus two or more dependents: The total premium is $123.34 which includes a State share of $92.51 and an employee share of $30.83

 

Delta Dental PPO plus Premier Enhanced Plan for Excluded Employees

  • Employee only: The total premium is $50.45
  • Employee plus one dependent: The total premium is $99.94
  • Employee plus two or more dependents: The total premium is $140.65 

 

Delta Dental Preferred Provider Option (PPO) for Excluded and Represented Employees

  • Employee only: The total premium is $44.24 which includes a State share of $33.18 and an employee share of $11.06
  • Employee plus one dependent: The total premium is $86.64 which includes a State share of $64.98 and an employee share of $21.66
  • Employee plus two or more dependents: The total premium is $130.69 which includes a State share of $98.02 and an employee share of $32.67

 

Prepaid Dental Plan 2014 Premiums

Premiums for DeltaCare USA, SafeGuard, Premier Access, and Western Dental will remain the same for 2014. The State pays 100% of the premium for employees not in CoBen. For employees in CoBen, the State's share and employee's share do not apply. Therefore, the total dental premium is deducted from the monthly CoBen allowance on their January 1, 2014, pay warrants (December 2013 pay period). Prepaid dental plans' premiums are as follows:

 

Employee only:

  • Safeguard Standard - $16.58
  • Safeguard Enhanced - $16.92
  • *Delta Care USA - $17.72
  • Premier Access - $16.63
  • Western Dental - $14.72

 

Employee plus one dependent:

  • Safeguard Standard - $26.86
  • Safeguard Enhanced - $28.63
  • *Delta Care USA - $29.07
  • Premier Access - $26.94
  • Western Dental - $24.29

 

Employee plus two or more dependents

  •  Safeguard Standard - $37.62
  • Safeguard Enhanced - $35.27
  • *Delta Care USA - $40.21
  • Premier Access - $37.73
  • Western Dental - $34.46
 

Comparison of Benefits and Covered Services

The following chart provides a comparison of costs for certain procedures covered by the State-sponsored dental plans. Please consult each dental plan's Evidence of Coverage for detailed information and plan limitations
 
Comparison of Dental Plan Benefits Chart
 

Union-Sponsored Dental Plans: Bargaining Units 5 and 6

The California Association of Highway Patrolmen (CAHP) offers its own indemnity dental plan to BU 5 employees who are CAHP members; however, members may opt to enroll in a State-sponsored prepaid plan. The California Correctional Peace Officers Association (CCPOA) provides dental insurance to BU 6 employees who are CCPOA members.

Employees in BU 5 and 6 should contact their Benefit Trust for information on their union-sponsored dental plan premiums and benefits.
 

Dental and Vision Plan Cobra Premiums

Publications

Forms

 

COBRA Forms

 

Additional forms and templates available to HR Pro's on HR Net.  

More Information

Please contact your HR Office if you have any questions.

Updated 6/16/2014