Enrollment Guidelines

These Enrollment Guidelines provide you with important information regarding:

• The Health & Welfare Benefits Plan (for employees in OCEA-represented bargaining units)

• OCEA’s members-only Supplemental Benefits Plans

Open-enrollment periods for the above plans are tentatively scheduled to begin in the Fall of each year. (Contact OCEA for current information regarding open enrollment.)

Health & Welfare Benefits Plan

The Health & Welfare Benefits Plan consists of four basic types of coverage:

• Dental
• Vision
• Basic Disability
• Life Insurance (with Accidental Death & Dismemberment coverage)

The exact nature of your coverage depends on which of the three “options” you choose. In general, Option 1 is for employees without dependents, Option 2 is for employees with dependents, and Option 3 is a “default” package. Part-time employees automatically fall within Option 3. However, all other covered employees should choose either Option 1 or Option 2, depending on their personal circumstances. Some helpful guidelines are found on the front page of the Health & Welfare Benefits Plan section of this guide. That page also has information on a 60-day time limit. Do not miss your time limit!

For assistance, contact OCEA at (714) 835-3355.

OCEA’s Members-Only Supplemental Benefits Plans

The principal supplemental (OCEA members-only) plans, which members may choose to purchase, are as follows:

•    Supplemental Dental
•    Supplemental Vision
•    Supplemental Disability
•    Supplemental Life Insurance
•    Supplemental Accidental Death & Dismemberment

Note: As used throughout this guide:
“Twice-Monthly” … means “two times per month” (twice per month, or 24 times per year).
“Biweekly”… means “one time per two-week period” (once every two weeks, or 26 times per year).

When Coverage or Payment Begins for Supplemental Plans

In all of the supplemental plans, OCEA will determine your effective date based on such factors as the following, where applicable: (a) the date you enroll in the plan, (b) the payday your payroll deductions are to begin, and (c) the date your evidence of insurability is approved.

The exact effective date of coverage of a plan, the date benefits become payable, and the period covered by the benefits, can depend upon a number of factors. These factors may include such items as those just mentioned, as well as your OCEA membership date and whether or not you are on a leave of absence. Among other things, you must be an “active” employee (actually at work) on the date you enroll in the plan and on the date coverage would otherwise become effective. (If you are on a leave of absence, you are not an “active” employee.)

The following sections provide further general information on effective dates for some of the supplemental plans offered by OCEA to its members. Remember, these are simplified rules. In the event of any conflict between the following and plan documents, the plan documents control.

For details, contact OCEA at (714) 835-3355.

Supplemental Life
Within 30 days of your OCEA membership date, you may apply for life insurance in an amount equal to your BAS (Base Annual Salary) or $60,000, whichever is less, without evidence of insurability. In all other situations, evidence of insurability is required.

Supplemental Life (for Dependents)
Your application must be received within 30 days of your OCEA membership date (otherwise evidence of insurability is required). Enrollment of the employee in supplemental life is a prerequisite to the enrollment of dependents.

Supplemental Disability
Your application must be received within 30 days of your OCEA membership date or during open enrollment (otherwise evidence of insurability is required). The effective date will be the first of the month following the 60-day period after the later of (a) the date your application is received or (b) your membership date.

Delta Dental PPO Plan A+
Your application must be received within 30 days of your OCEA membership date, during open enrollment or a life changing event.

DeltaCare CAM42 (DHMO)
Your application must be received within 30 days of your OCEA membership date, during open enrollment or a life changing event.