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If you qualify for an exception to the six-month waiting period (see Manage Your Enrollment > Waiting Periods and Exceptions), coverage begins on the first day of the month following the month btiÌåÓý receives your Medical Plan Change Form, provided btiÌåÓý receives your form by the 15th of the month. However, if your change is to enroll in a Medicare Advantage Prescription Drug (MAPD) HMO, coverage begins the first day of the second month following the date btiÌåÓý receives your form, provided it is received by the 15th of the month. This delay in MAPD plan coverage is due to the required authorization from Centers for Medicare and Medicaid Services (CMS), the federal government agency that administers Medicare.

How to Change Dental Plans

1. Contact us to request a Dental/Vision Enrollment Change Form.
2. Fill out the Dental Enrollment Change Form completely, and be sure to sign, date, and keep the bottom copy for your personal records.
3. Mail, fax, upload, or email the rest of the form back to btiÌåÓý
   • Mail: P.O. Box 7060 Pasadena, CA 91109-7060
   • Fax: 626-564-6155
   • Upload your documents on
   • Email: healthcare@lacera.com
4. The waiting period begins the date that btiÌåÓý receives the change form. Coverage takes effect the first day of the month after completion of the one-year waiting period.

If you qualify for an exception to the waiting period, your plan change is effective the first day of the month following your request, if your change form is received by the 15th day of the month. For example, if your form is received by June 15, your plan change will be effective July 1 of the next month.