HomeMy WebLinkAboutC27650 - CA6 - Delta Dental CITY OF PALM DESERT
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HUMAN RESOURCES DEPARTMENT
STAFF REPORT
REQUEST: Request for approval of amendment No. 6 to Contract No. C27650
with Delta Dental, to be in compliance with the Affordable Care Act
(2010 Health Care Reform) by providing coverage to dependants
up to age 26.
SUBMITTED BY: Lori Carney, Human Resources Manager
CASE NOS. N/A
DATE: January 24, 2013
CONTENTS: Staff Report
Amendment No. 6 to Contract No. C27650
Recommendation:
By Minute Motion authorize Mayor to approve Amendment No. 6 to Contract No.
C27650 with Delta Dental, providing dependant coverage up to age 26.
Backqround:
The Patient Protection and Affordable Care Act was enacted on March 23, 2010, by the
Federal Government. It contains a number of provisions which became and become
effective over the course of several years — being fully effective in 2014. One of the
provisions is that group health insurance plans that offer dependent coverage allow
dependants to remain on their parents plan up to age 26.
Delta Dental is amending our contract for dental services to reflect concordance with
this provision. Employee dependants covered under their parents health and vision
plans will be allowed to remain on the plan through age 26.
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Staff Report
Delta Dental Contract No. C27650 Amendment No. 6
January 24, 2013
Page 2 of 2
There is no increase in the premiums for this plan year. Our contract agreement expires
June 30, 2013.
Fiscal Analvsis
No increase in cost per employee, the current contract funds are available in the FY
2012/2013 budget.
Submitted by:
Lori Carney,
Human Re urces Manager
Approval:
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Jo n Wohlmuth, Paul Gibson,
ty Manager Finance Director
C1TY COUNCILACTION
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AMENDMENT NO. 6 TO AGREEMENT
GROUP #00065
AGREEMENT dated ]uly 1, 2007, between CITY OF PALM DESERT and DELTA DENTAL OF
CALIFORNIA "Delta Dental," is hereby amended, effective January 1, 2013, as foilows:
Sub-paragraph 1 of Paragraph 2.3 is amended to read:
Dependents are the Primary Enrollee's legai spouse or registered domestic partner and
dependent children from birth to age 26. Children include natural children, stepchildren,
adopted children, children placed for adoption and foster children. The Dependents of Primary
Enrollees are eligible to enroll on the same date that the employee, of whom they are a
Dependent, becomes a Primary Enrollee. Later-acquired Dependents become eligible as soon
as they acquire dependent status.
Paragraph 2.4 is amended to read:
2.4 A dependent child may continue eligibility if:
a) He or she is incapable of self-sustaining employment because of a physically or mentaliy
disabling injury, illness or condition that began prior to reaching the limiting age;
b) He or she is chiefly dependent on the eligible employee for support; and
c) Proof of dependent's disability is provided within 60 days of request. Such requests will
not be made more than once a year following a two year period after this dependent
reaches the limiting age. Eligibility will continue as long as the dependent relies on the
Eligible Employee for support because of a physically or mentally disabling injury, illness
or condition that began before he or she reached the limiting age.
1
CITY OF PALM DESERT
DELTA DENTAL GROUP NUMBER 00065
Date Amendment Signed:
By:
Signature
Printed Name
Title
DATE: September 25, 2012
DELTA DENTAL OF CALIFORNIA
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Belinda Martinez
Senior Vice President
Sales/Marketing
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Kevin Jackson
Group Vice President
Underwriting &Actuarial Services