Beneficiary -
Person designated by a participant to receive benefits provided by the plan if the participant dies.
Twice-Monthly - As used throughout this guide, this term means “two times per month” (that is, twice per month, or 24 times per year).
Biweekly - As used throughout this guide, this term means “one time per two-week period” (that is, once every two weeks, or 26 times per year).
Cities and Districts - Municipalities, districts, agencies, and political subdivisions within the County of Orange.
Copayment - The dollar amount you must pay each time a specified service is provided.
Deductible - The annual dollar amount that you must pay for services before benefits become payable by the insurance carrier.
Eligible Dependent -
- Your legal spouse
- Your registered domestic partner
- Your children can be covered under your dental and vision plans until they reach age 26:
- Child can be married or unmarried.
- Child does not need to be a full-time student.
- Any child of the employee regardless of dependency status under IRS rules.
- Child must not be eligible for any other Employer dental and/or vision plan.
- Spouses and children of dependent children are not eligible for coverage.
Note: "Children" includes stepchildren and adopted children, provided they are chiefly dependent upon you for support and maintenance. Foster children are excluded.
Evidence of Insurability - Any written statement of proof of a person’s overall health status required by the insurance carrier prior to acceptance for insurance.
Full-Time Employee - An employee employed in one or more regular or limited-term positions whose normally-assigned work hours equal those of a full work-week (40 hours or more per week) or work-period.
OCEA-Represented Bargaining Units - Community Services, County General, Fire Authority General, Fire Authority Supervisory Management, Healthcare Professional, Law Library, Office Services, Probation Services, Probation Supervisory Management, Sheriff’s Special Officer/Deputy Coroner, Superior Court Clerk, Superior Court General, Superior Court Supervisor, and Supervisory Management.
Open Enrollment - A period of time each year when you may change your benefit elections without a family status change.
Part-Time Employee - An employee employed in one or more regular or limited-term positions whose normally-assigned work hours do not equal those of a full-time employee (less than 40 hours per week, but not less than 40 hours in a pay period).
Plan Year - January 1 through December 31.
Predetermination - A predetermination is a free service that Delta Dental provides to its subscribers. It can help you and your dentist make better choices about your dental care. A predetermination is particularly useful for more costly procedures such as crowns, wisdom teeth extractions, bridges, dentures, or periodontal surgery. When your dentist predetermines treatment with Delta Dental, you’ll receive an estimate before treatment begins of your share of the cost and how much Delta Dental will pay.
Retiree - You are a retiree eligible to purchase retiree benefits if you are a current member of the Retired Employees Association of Orange County (REAOC) and you are or will be receiving a retirement check from the Orange County Employees Retirement System (OCERS).
Usual, Customary and Reasonable Charge (UCR) - Fees that are regularly charged and are in the range of fees customarily charged for the same service or supply in the geographic area concerned.
Waiting Period - The period of time you must complete before benefits are payable.
