Retirees and dependents For an eligible retiring employee or retiring school employee and their eligible dependents, dental coverage begins on the first day of the month after the employer-paid coverage, COBRA coverage, or continuation coverage ends. For an eligible employee or school employee determined to be retroactively eligible for disability retirement and their eligible dependents, dental coverage begins on the date chosen by the employee or school employee as allowed under PEBB Program rules. For an eligible elected or full-time appointed official and their eligible dependents, dental coverage begins the first day of the month following the date the official leaves public office. For an eligible retiree who deferred enrollment and is enrolling in a PEBB retiree health plan following loss of other qualifying coverage, dental coverage for the retiree and their eligible dependents begins the first day of the month after the other qualifying coverage ends. Survivors and dependents For an eligible survivor of a retiree and their eligible dependents, dental coverage will be continued without a gap, subject to payment of premiums and applicable premium surcharges. If the eligible survivor is not enrolled at the time of the retiree’s death, dental coverage will begin the first day of the month following the retiree’s death. For an eligible survivor of an employee or school employee and their eligible dependents, dental coverage begins the first day of the month following the later of the date of the employee’s or school employee’s death or the date the survivor’s PEBB insurance coverage, educational service district coverage, or SEBB insurance coverage ends. This does not include emergency service personnel killed in the line of duty. For an eligible survivor of emergency service personnel killed in the line of duty and their eligible dependents, dental coverage begins on the date chosen, as allowed under PEBB Program rules. For an eligible survivor who deferred enrollment and is enrolling in a PEBB retiree health plan following loss of other qualifying coverage, dental coverage for the survivor and their eligible dependents begins the first day of the month after the other qualifying coverage ends. Continuation coverage subscribers and dependents For a continuation coverage subscriber and their eligible dependents enrolling when newly eligible due to a qualifying event, dental coverage begins the first day of the month following the day they lost eligibility for PEBB dental plan coverage. All subscribers and dependents For a subscriber or their eligible dependents enrolling during the PEBB Program’s annual open enrollment, dental coverage begins January 1 of the following year. For a subscriber or their eligible dependents enrolling during a special open enrollment, dental coverage begins the first day of the month following the later of the event date or the date the required form is received. If that day is the first of the month, dental coverage begins on that day. If the special open enrollment is due to the birth or adoption of a child, or when the subscriber has assumed a legal obligation for total or partial support in anticipation of adoption of a child, dental coverage will begin as follows: • For an employee, dental coverage will begin the first day of the month in which the event occurs. • For a newly born child, dental coverage will begin the date of birth. • For a newly adopted child, dental coverage will begin on the date of placement or the date a legal obligation is assumed in anticipation of adoption, whichever is earlier. • For a spouse or state-registered domestic partner of a subscriber, dental coverage will begin the first day of the month in which the event occurs. If the special open enrollment is due to the enrollment of an extended dependent or a dependent child with a disability, dental coverage will begin the first day of the month following the event date or eligibility certification, whichever is later. 2024-01-03000-BB 23 LG PPOL 20240101