This PML is superseded by the HR Manual and is no longer active.
PML Number
2005-024
Title
Six Month Limitation of Retroactive Dental Premium Reimbursements
Date Issued
August 9, 2005
Owner
Benefits Division
Contact
William Page
Staff Personnel Program Analyst
(916) 445-9801
WilliamPage@DPA.CA.GOV
Signed By
Debbie Endsley, Division Chief, Benefits Division
Content
This memo provides information regarding a limitation of retroactive dental premium reimbursements, in accordance with the recent regulation amendments which limit reimbursement of health premiums (See CalPERS Circular Letter, 600-215-05, dated April 29, 2005).  The following changes will impact all mandatory cancellations and/or deletions to employees’ State-sponsored dental coverage.
Effective January 1, 2006, retroactive premiums for mandatory cancellations and/or deletions to employees’ dental coverage will be reimbursed for a maximum period of six months.  Personnel Offices should communicate the importance of submitting dental enrollment changes to their departments in a timely manner.  Personnel Offices may also want to refer employees to the Dental Benefits Handbook for Active and Retired Employees on DPA’s Web site at DPA.ca.gov (click on Benefits, then click on Dental Insurance, under Related Publications).  To assist you in communicating information regarding the limitation of retroactive dental premium reimbursements, we have provided you with a memo (Attachment II) that should be distributed to all your employees.
COMPLETING THE DENTAL PLAN ENROLLMENT AUTHORIZATION (STD. 692)
When completing the Dental Plan Enrollment Authorization (STD. 692) for mandatory cancellations and/or deletions of coverage, the Personnel Office should continue to reflect the actual permitting event date that caused the loss of eligibility and the mandatory effective date/pay period, and forward the form to the State Controller’s Office (SCO) for processing.  When the form is processed by SCO, the premiums will be adjusted for a maximum period of six months.
The following example of how SCO will process a retroactive transaction is based on an employee who had a divorce (mandatory deletion of spouse) on 08/04/04, but did not report the divorce to the Personnel Office until 08/05/06.
Example:
STD. 692 signed by Personnel Office: 08/05/06
STD. 692 received at SCO: 08/11/06
Effective date shown in Section E-14 on STD. 692: 09/01/04
Six month retroactive effective date on SCO records: Ex-spouse deleted 03/01/06  (02/06 pay period)
The department and employee will not be able to recover any premiums paid prior to the 03/01/06 retroactive effective date (02/06 pay period).  Additionally, the employee may be responsible for any dental services that have been incurred by the ex-spouse from 03/01/06 through 09/01/06 and any services incurred after the deletion is processed (if the ex-spouse continues to use this coverage).
DENTAL PROGRAM PERMITTING EVENT CODES IMPACTED BY CHANGE
Attachment I lists the dental program permitting event codes that will have a six month limitation of retroactive dental premium reimbursements when the STD. 692 is processed by SCO.
IMPACT ON VISION ENROLLMENT
State employees’ vision coverage is automatically established for eligible employees and their eligible dependents and no form is required to delete ineligible dependents.  Therefore, employees need to continue to ensure that only eligible dependents are provided services under their State-sponsored vision plan.
PERSONNEL OFFICES
Please ensure that your employees are made aware of this change and the importance of making timely deletions of ineligible dependents to their dental coverage.  Thank you for your cooperation.  If you have any questions regarding this information, you may contact William Page, Staff Personnel Program Analyst, at (916) 445-9801.