California Code of Regulations
Title 10 - Investment
Chapter 5.7 - Voluntary Alliance Uniting Employers Purchasing Pool (the Health Insurance Plan of California)
Article 2 - Participation Requirements, Application and Enrollment
Section 2699.6129 - Application for Dental Benefits Coverage

Universal Citation: 10 CA Code of Regs 2699.6129

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) Applications for dental benefits shall be in addition to the applications for participation in the program pursuant to Sections 2699.6121, 2699.6123, 2699.6125, and 2699.6127.

(b) Small employers or guaranteed associations may elect the dental coverage option at the following times:

(1) During the special initial election for dental benefits coverage pursuant to Section 2699.6157, or

(2) At the time of application for the program, or

(3) During open enrollment pursuant to Section 2699.6143.

(c) Small employers shall submit the following in an application for dental benefits:

(1) A declaration that 100% of the eligible employees participating in the program for health benefits will purchase dental benefits.

(2)
(A) For small employers who have an effective date of coverage prior to September 1, 1998, who have not made an election pursuant to Section 2699.6116, a declaration that the small employer is contributing an amount equal to at least 50% of the monthly "employee only" rate of the lowest "employee only" rate available to the eligible employee for dental benefits coverage.

(B) For small employers who have an effective date of coverage on or after September 1, 1998, or who have made an election pursuant to Section 2699.6116, a declaration that the small employer is contributing an amount equal to at least 50% of the lowest available monthly "employee only" comprehensive individual dental premium.

(3) Payment of an amount equal to the initial one month dental benefits premium or the sum of the initial one month comprehensive individual dental premiums as applicable. This shall be paid as part of the employer premium except during the special initial election for dental benefits coverage pursuant to Section 2699.6157 when the initial one month dental benefits premium may be paid before the employer premium to facilitate an earlier effective date for dental benefits.

(4) An application for each eligible employee which indicates:
(A) Name, address, and Social Security Number, as defined in Section 2699.6000, of each eligible employee applying for dental benefits.

(B) The employee's and dependent's, if applicable, dental insurance information, including the carrier name and address of:
1. Any current dental insurance or other dental benefits.

2. Most recent prior dental insurance or other dental benefits.

(C) Which dental benefit plan the eligible employee is selecting for dental benefits.

(d) Individual members shall submit the following in an application for dental benefits:

(1) Name, address, and Social Security Number, as defined in Section 2699.6000, of the individual member,

(2) The individual member's and dependent's, if applicable, dental insurance information, including the carrier name and address of:
(A) Any current dental insurance or other dental benefits.

(B) Most recent prior dental insurance or other dental benefits.

(3) Which dental benefit plan the individual member is selecting for dental benefits.

(4) Payment of an amount equal to the initial one month dental benefit premium or the comprehensive individual dental premium as applicable. This shall be paid as part of the individual member premium, except during the special initial election for dental benefits coverage pursuant to Section 2699.6157 when the initial one month dental benefits premium may be paid before the individual member premium to facilitate an earlier effective date for dental benefits.

(e) If a guaranteed association elects the dental benefit option, a guaranteed association shall certify in its application that all individual members of the guaranteed association will be purchasing dental benefits from the program.

1. New section filed 5-23-94 as an emergency; operative 5-23-94 (Register 94, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-20-94 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 5-23-94 order transmitted with amendment of subsections (b)(1), (c)(3) and (d)(4) to OAL 9-16-94 and filed 10-27-94 (Register 94, No. 43).
3. Amendment of subsection (b)(3) filed 12-29-94 as an emergency; operative 12-29-94 (Register 94, No. 52). A Certificate of Compliance must be transmitted to OAL 4-28-95 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 12-29-94 order transmitted to OAL 4-12-95 and filed 5-22-95 (Register 95, No. 21).
5. Redesignation and amendment of former subsection (c)(2) to new subsection (c)(2)(A), new subsection (c)(2)(B), and amendment of subsections (c)(3) and (d)(4) filed 7-3-98 as an emergency; operative 7-3-98 (Register 98, No. 27). A Certificate of Compliance must be transmitted to OAL by 11-2-98 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 7-3-98 order transmitted to OAL 10-2-98 and filed 11-16-98 (Register 98, No. 47).

Note: Authority cited: Section 10731, Insurance Code. Reference: Section 10731, Insurance Code.

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