1. (a) Only enrollees who qualify for and receive health benefits coverage in the program shall be eligible to receive dental benefits coverage through the program.

2. (b) If a small employer elects the dental benefit option:

   1. (1) 100% of the eligible employees participating in the program for health benefits shall participate in the program for dental benefits, and any dependents enrolled for health benefits shall be enrolled for dental benefits, with the exception that dependents under the age of two years are not required to participate, and

      1. (B) For sole 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, and member employers whose guaranteed association has an effective date of coverage on or after September 1, 1998, or made an election pursuant to Section 2699.6116, for each such employee a small employer shall contribute an amount equal to at least 50% of the lowest available monthly employee only comprehensive individual dental premium.

      (2)(A) For sole employers who have an effective date of coverage prior to September 1, 1998, who have not made an election pursuant to Section 2699.6116, and member employers whose guaranteed association has an effective date of coverage prior to September 1, 1998 and did not make an election pursuant to Section 2699.6116, for each such employee a small employer shall contribute an amount equal to at least 50% of the monthly “employee only” rate of the lowest “employee only” rate available to the employee for dental benefits.

3. (c) If a qualified guaranteed association elects to make the dental benefit option available to individual members, 100% of the individual members of the qualified guaranteed association participating in the program for health benefits shall participate in the program for dental benefits and any dependents enrolled for health benefits shall be enrolled for dental benefits, with the exception that dependents under the age of two years are not required to participate.

Note: Authority cited: Section 10731, Insurance Code. Reference: Sections 10731 and 10741, Insurance Code.

History

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 A Certificate of Compliance must be transmitted to OAL by 9-20-94 or emergency language will be repealed by operation of law on the following day.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 subsection (b)(1) to OAL 9-16-94 and filed 10-27-94 (Register 94, No. 43).

3. Redesignation and amendment of former subsection (b)(2) to new subsection (b)(2)(A) and new subsection (b)(2)(B) 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.

4. Certificate of Compliance as to 7-3-98 order transmitted to OAL 10-2-98 and filed 11-16-98 (Register 98, No. 47).