Human Resources

Dental Insurance

The dental insurance plan offers comprehensive coverage, including orthodontia, that meets your individual and family needs.

Quick Access to this Site	Dental Insurance Resources
Eligibility	Tax Treatment of Non-Qualified Tax Dependents
Non-Qualified Tax Dependents	Delta Dental Benefits Certificate (effective 01/01/09)
Double Spouse Credit
Enrollment	Dental Insurance Application
Qualified Life Events	State of Iowa Delta Dental Application
Delta Dental Benefit Summary
Monthly Premiums
COBRA
For More Information

Eligibility

You are eligible for dental insurance if you are a permanent or probationary employee and work 20 hours or more a week. You should contact your Personnel Assistant to verify your eligibility for coverage.

Dental insurance offers two levels of coverage:

• Single
• Family

Dependents eligible for coverage in a Family plan are:

• Your spouse (A husband or wife as the result of a marriage that is legally recognized in Iowa. This does not include a spouse from whom you are legally separated or divorced.)
• Your domestic partner (same sex or opposite sex are eligible for domestic partner coverage)
• Your dependent child (children)

Eligible Dependent Child (Children)

An eligible dependent child is:

• Your natural child
• A child placed with you for adoption or a legally adopted child
• A child for whom you have legal guardianship
• A stepchild
• A foster child

You may be required to provide documentation that a dependent is eligible as defined above.

A dependent child must be unmarried and must be one of the following:

• Under age 19
• Between ages 19 through 25, not a full-time student, and resides in the state of Iowa
• A full-time student in an accredited institution of postsecondary education regardless of age
• Totally and permanently disabled, physically or mentally, regardless of age. The disability must have existed before the dependent child turned age 25 or while the dependent child was a full-time student and continuously covered on a Delta Dental contract.

Annually, DAS-HRE requires written verification that a dependent child, age 19 or older, is a full-time student. The verification process requires the employee to provide a copy of the dependent child’s most recent transcript or class schedule.

The verification will be mailed to the employee’s home and must be returned to DAS-HRE before the end of the dependent child’s birth month. Failure to return the required verification information results in the dependent child’s termination from insurance on the first day of the month following the dependent child’s birthday.

Non-Qualified Tax Dependents

There are tax consequences if an unmarried dependent, between ages 19 through 25, who is not a full-time student, is enrolled in your dental insurance plans.

The IRS does not permit favorable tax treatment for an unmarried dependent that is between the ages of 19 through 25 and not a full-time student. These individuals are not considered “dependents” by the IRS. Since these individuals are not tax dependents per the IRS, you will be taxed on the value of the dependent’s coverage. The state has determined the fair market value of dependent coverage and will include the value of the non-qualified tax dependent’s coverage in your gross income. You may want to consult your tax advisor if you have any questions.

The value of the non-qualified dependent’s coverage is based on:

• The number of non-qualified tax dependents enrolled on your plan
• The insurance plan you have elected

Detailed information on the tax treatment of non-qualified tax dependents including the added value table, form and an example is available at the DAS Benefits Web site.

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Double Spouse Credit

When spouses are employed by the state, at the option of the couple, one family plan may be elected. The state's contribution to double-spouse family coverage will be equal to two single contributions. When spouses are employed by the state and one spouse is a full-time employee and one spouse is a benefits-eligible part-time employee, at the option of the couple, one family plan may be elected. The state's contribution to the above stated double-spouse family coverage will not exceed the full family premium. If both spouses are benefits-eligible part-time employees, the state's share of the premium for each employee will be one-half of the state’s share of the full-time double-spouse family premium. When spouses are employed by the state, and one spouse is a non-Regents employee and the other spouse is a non-merit Regents employee, at the option of the couple, one family plan may be selected. The family plan selected shall come from those plans administered by the Department of Administrative Services.

If both Spouses are Eligible Employees of the State

When spouses are both employed by the state, they must enroll under the same family coverage. Employees cannot be covered as both an employee and a dependent under the state’s health and welfare benefit plans. Employees have four coverage choices under the health plans:

1. Each spouse may enroll separately in single coverage.
2. One spouse may elect single coverage and the other spouse may enroll themselves and dependent(s) in family coverage. The spouse selecting single coverage may not be listed as a dependent on the family plan.
3. One spouse may elect to waive coverage and the other spouse may enroll both spouses and dependent(s) in family coverage.
4. Both spouses may elect family coverage for themselves and their dependent(s) under double-spouse family coverage with one spouse being the contract holder and one being the contributing spouse.

More information about the double spouse family credit is available at the DAS Benefits Web site.

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Enrollment

You may enroll in the dental plan during the first 30 days of your employment. You may only add dependents during your initial enrollment or as a result of a qualifying event.

If you do not elect dental coverage during the first 30 days of your employment, you may not be eligible to join the plan later.

To enroll in the dental plan, please see your Personnel Assistant.

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Qualified Life Event

When you enroll in dental insurance, your election remains in effect to the end of the calendar year. You cannot add eligible family members until the next designated OPEN dental enrollment opportunity unless you experience a qualified life event and the benefit change you request is consistent with the event.

If you experience a qualified life event, you can request changes by notifying your Personnel Assistant within 30 days after the date of the event (60 days for birth and adoption.) If you do not notify your Personnel Assistant within the required timeframe following the event, you will not be able to change your benefits until the next designated OPEN dental enrollment opportunity.

For additional information on qualified life events, review the DAS Qualified Life Events Web site.

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Dental Benefit Summary

Dental coverage is provided by Delta Dental of Iowa. The plan provides comprehensive coverage for you and your eligible family members.

Delta Premier	Deductible	Coinsurance	Maximum per Calendar Year	Lifetime Maximum
Benefit Categories	None	--	$1,500	--
Check Ups and Teeth Cleaning	--	0%	Yes	--
Cavity Repair and Tooth Extractions	--	20%	Yes	--
Roots Canals	--	50%	Yes	--
Gum and Bone Diseases	--	50%	Yes	--
High Cost Restorations	--	50%	Yes	--
Bridges and Dentures	--	50%	Yes	--
Orthodontics *	--	50%	NA	$1,500

*Orthodontic coverage is only available for unmarried dependents under age 19.

Delta Dental payment is based upon the dentist's usual, customary and reasonable fee.

For detail information about the dental plan, refer to the Delta Dental Benefits Certificate.

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Monthly Premiums

AFSCME, AFSCME Judicial, Judicial (Non-Contract), Non-Contract (Non-Judicial) and PPME-covered
UE/IUP-covered

When you and your spouse are both employed by the state of Iowa, you may want to take advantage of the double spouse family credit. The double spouse family credit provides family dental insurance coverage with a reduced employee share towards the monthly premium. Contact your Personnel Assistant if you have any questions or need an enrollment form.

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COBRA

COBRA Continuation Coverage Rights

If you leave state employment, the federal Consolidated Omnibus Budget Reconciliation Act (COBRA) provides for continuation of dental benefits coverage at the group premium rate after your coverage with the state ends. However, certain events must occur for any persons covered under your contract to be eligible.

COBRA Qualifying Events	Maximum Eligibility Period Beyond Termination
Employee Termination/ Resignation	The employee and covered dependents have 18 months of COBRA eligibility. If the employee meets the Social Security Administration’s definition of disabled at any time during the first 60 days of COBRA coverage, the employee and covered dependents have 29 months of COBRA eligibility.
Death or Divorce of Employee	The covered dependents have 36 months of COBRA eligibility.
Employee Reduces Work Hours; No Longer Eligible for Coverage	The employee and covered dependents have 18 months of COBRA eligibility.
Employee’s Dependent No Longer Eligible (Age 19 to 25 and no longer a full-time student, marries, or no longer resides in the state of Iowa)	The covered dependent has 36 months of COBRA eligibility.
Employee on Active Military Duty	The employee and covered dependents have 24 months of COBRA eligibility.

The state’s share of the premium payment for health and dental benefits will cease at the end of the month in which the qualifying events occurs, and you will be responsible for full payment of the premium.

2009 Dental Insurance COBRA Rates

COBRA coverage begins the first of the month following the qualifying event. The COBRA election period is 60 days after the later of:

• the date coverage would otherwise end, or
• the date of the COBRA Notification/Election Form.

If your employment ends, the DAS will mail a COBRA Notification/ Election Form to you within two weeks following your last paycheck. The notification includes monthly benefit costs and election instructions. In the event of the death of an active employee, the family will receive notice of their COBRA rights. If an employee divorces, reduces hours, or has a dependent that is no longer eligible for coverage, the employee must notify his or her Personnel Assistant within 60 days following the event so that the Personnel Assistant can send the COBRA information.

NOTE: COBRA rights will not be extended to a Domestic Partner or his/her children, if the relationship terminates, if the employee terminates from state employment, or if the domestic partner’s children have an event that makes them ineligible for employee’s plan.

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For More Information

If you would like more information about Delta Dental please contact:

DELTA DENTAL PLAN OF IOWA
2401 SE Tones Drive, Suite 13
Ankeny, IA 50021

800-544-0718
515-261-5573 FAX
www.deltadentalia.com

For questions regarding your particular plan please contact your Personnel Assistant.

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Site updated 10/08/2009