Current through Register Vol. 56, No. 18, September 16, 2024
(a) The Employee
Dental Plans were established under the provisions of 52:14-17.29(F)
and were extended to local participating employers as of January 1,
2005. The Employee Dental Plans are available to full-time employees and their
eligible dependents. Newly eligible employees may enroll by completing an
application during the first 60 days of employment. The Employee Dental Plans
offer a choice between two types of dental plans: a Dental Expense Plan and a
Dental Plan Organization (DPO). The Dental Expense Plan is a PPO that allows
the employee to select any licensed dentist for dental care. The Dental Plan
Organizations (DPOs) are companies that contract with a network of providers
for dental services. The employee must use providers participating with the DPO
selected.
(b) The Plans are
voluntary. A separate election will be required for enrollment and for a change
in, or a voluntary termination of, coverage in the Employee Dental
Plans.
(c) The rules are the same
as those of the SHBP as administered by the Commission in accordance with the
provisions of N.J.S.A. 52:14- 17.25 et seq., with the following exceptions:
1. Coverage may be continued during an
approved leave of absence without pay of not more than three months (six
biweekly pay periods) provided the employee pays the entire premium in advance
(employer and employee shares of the premium for employees and
dependents);
2. All employees
enrolled for coverage are required to participate in the Plan for a minimum
12-month period while eligibility for coverage exists unless the minimum
enrollment requirement is waived by the Commission;
3. An employer who participates in the
Employee Dental Plans is not eligible to request a premium delay of 30 or 60
days for payment of the premium charges pursuant to
17:9-5.2(a);
4. If an employer elects to participate in
the Employee Dental Plans, the employee's share of the cost for the Plans may
be determined by a formula different from that used to determine the employee's
share of the cost of health coverage. The employee may pay a share of the cost
of dental coverage for the employee and for the employee's covered dependents
as required by a collective negotiations agreement. The employer may establish
by ordinance or resolution, rules for the employee's share of the cost for
those employees not covered under a collective negotiations
agreement;
5. An employer who does
not participate in the SHBP or School Employees' Health Benefits Program is
ineligible for participation in the Employee Dental Plans; and
6. An employer who elects to participate in
the Employee Dental Plans must remain in the Plans for a minimum of 12 months
before terminating coverage unless the employer terminates participation in the
SHBP or School Employees' Health Benefits Program.
