Benefits

Health Benefits

Our benefits program is just one way the CSU demonstrates its dedication to your success and well-being. We want you to rest assured knowing you and your family’s health and future are being looked after. Comprehensive and flexible coverage options allow you to choose a plan that best suits your needs.

Eligibility for CSU Benefit Programs

To be eligible, you must be employed half time or more in an appointment that exceeds six months and one day. Temporary faculty (AY Classification) must have 6.0 units or more for at least one semester, including the current semester. If you do not meet the standard benefits eligibility but are hired at least at a .75 timebase, you are eligible to enroll in health (medical only), regardless of appointment duration.

Part Time Faculty Eligibility Information

A picture of a stethoscope on a paper form

Health Maintenance Organizations (HMO) Plans

An HMO is a plan that provides healthcare from specific doctors and hospitals under contract with the plan. Employees and their eligible dependents select a primary care physician who coordinates all medical care including referrals to specialists. The employee and eligible dependents can each select a different primary care physician/medical group within the HMO plan. These plans generally have restricted service areas in California (based on zip code), co-payments for some services, no deductibles, and no claim forms. Emergency services rendered out of the service area or California must be reported to the HMO plan.

HMO Provider List

Preferred Provider Organizations (PPO) Plans

As a PPO health plan member, you get maximum benefit coverage when you use the PPO network (Blue Cross of California) of physicians and hospitals. A PPO is similar to a traditional "fee-for-service" plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). A PPO allows you to select a primary care provider and specialists without referral. In these plans, you must usually meet an annual deductible before some benefits apply. You are responsible for a certain co-insurance amount, and the plan pays the balance up to the allowable amount.

PPO Provider List

Benefit eligible employees may enroll in one of two dental plans for themselves and their eligible dependents. The premiums for these dental plans are paid by the CSU. Both plans are administered by Delta Dental.

Within 60 days of your hire or eligibility, please complete the Benefits Enrollment Worksheet in Adobe Sign to make a dental plan election. If you have questions about completing the Benefits Worksheet or wish to obtain additional information, contact Human Resources at (559) 278-2032.

Picture of a tooth and classes on a dental insurance form

DeltaCare USA (HMO)

DeltaCare USA is a prepaid dental plan that offers many services at no cost to employees, although some may require a co-payment. Your level of coverage is determined by your collective bargaining unit. Enrollees and their eligible dependents must use a dentist who is a contracted DeltaCare provider, as most basic services may be fully covered. Please consult your dentist regarding the costs and coverage of the services to be rendered. When enrolling in DeltaCare USA, you must select a provider from their list, which can be found in the Directory of Dentists. Similar to a Health Maintenance Organization (HMO), you will receive a membership card and an evidence of coverage document detailing your benefits.

DeltaCare® USA website

Delta Dental (PPO)

The Delta Dental plan is a group dental plan that offers enrollees the flexibility to choose any dentist. However, the benefits outlined in the Summary Brochure are guaranteed only when services are rendered by a Delta member dentist. The level of dental coverage available to you is determined by your collective bargaining unit. Members can opt for a dentist within the Delta Premier or Delta PPO network to benefit from reduced costs. The plan specifies the maximum amount it will pay for various types of dental treatments, and any remaining balance is the responsibility of the member. For detailed information on covered benefits, you can refer to the Evidence of Coverage. Additionally, if you receive services from a non-Delta dentist, you will need to complete and submit your own claim forms.

Delta Dental CA

All benefit eligible employees appointed half-time or more for a period of more than six months, and their eligible dependents, are automatically enrolled in the basic vision insurance plan.

Premiums are paid by the CSU.
May visit any licensed ophthalmologist, optometrist or dispensing optician of choice.
By choosing a participating provider in the Vision Service Plan (VSP) network, the insurance will cover more out-of-pocket costs.
Administrator is Vision Service Plan (VSP).

All benefit eligible employees and their eligible dependents, also have an option to enroll in the Vision Premier Plan as a new hire, if a qualifying event occurs outside of Open Enrollment, or during Open Enrollment. There is a monthly out of pocket premium paid for by the employee. Review the comparison.

Basic Vision Plan

One comprehensive eye exam every calendar year.
One pair of lenses every other calendar year (or calendar year if your prescription changes) and one frame every other calendar year.
Contact lenses every other calendar year when contact lenses are provided in lieu of all other lens and frame benefits.
$110 - $130 frame allowance
$0 copay for UV protection
$120 allowance for contacts and exam

Premier Vision Plan

One comprehensive eye exam every calendar year.
One pair of lenses every calendar year and one frame every calendar year.
Contact lenses every other calendar year when contact lenses are provided in lieu of all other lens and frame benefits.
$210 - $230 frame allowance
$0 copay for UV protection, tinted lenses, and standard progressive lenses
$200 allowance for contacts and exam

VSP Plan Comparison

VSP Vision Care Website

Looking for more information on the other voluntary and flexible benefits available to Fresno State employees? Visit our Voluntary and Flexible page for information on:

HCRA/DCRA
Flex Cash
Pre-Tax Savings Plans
Fee Waiver
Paid Life Insurance
... and more!

Voluntary & Flexible Benefits

Additional Information

Employee Benefits Summary

Health Benefit Plan Rates

CalPERS Health Website

The deadline for enrolling in benefits (health, dental, vision, or FlexCash) is 60 days from the date of hire. If the deadline is missed, employees may enroll in health insurance after a 90-day waiting period under the Health Care Portability and Accountability Act (HIPPA), or during the annual open enrollment period with coverage effective the following January 1.

Benefits will become effective on the first day of the following monthly pay period that the Benefits Worksheet form is received by the Human Resources Office.

Example
Hire date: July 29th
Benefits Worksheet is received by Human Resources: August 10th
Effective date of health benefits: September 1st.

Monthly plan premium costs are shared by the CSU and the employee. Employee contribution rates vary depending on the plan selected and the number of dependents enrolled. It is essential to evaluate each plan against your personal and family needs prior to making a selection.

The medical plans are administered by the California Public Employees Retirement System (CalPERS). No dual enrollment or split enrollments are allowed.

The Benefits Worksheet must be completed along with appropriate documents/information required and returned to the Human Resources Office, Joyal Administration Building, Room 211 on or before the 60-day time limit. Alternatively, you can also upload the documents via MoveIT. The effective date of enrollment is the first of the following month that the Benefit Worksheet is received in the Human Resources Office.

You and your spouse or registered domestic partner can enroll in the CalPERS Health Program separately if you both work, or worked, for agencies in the CalPERS Health Program.

If you choose to enroll separately, one parent must carry all dependents on one health plan. Dependents cannot be split between parents. For example, if a CalPERS member with children marries another CalPERS member with children and each member has their own enrollment in the CalPERS Health Program, then all children must be enrolled under one parent.

If split enrollments are discovered, they will be retroactively corrected. You will be responsible for any costs incurred from the date the split enrollment began.

You cannot be enrolled in a CalPERS health plan as both a member and a dependent or as a dependent on two enrollments. This is called dual coverage and it is against the law for CalPERS. When dual coverage is discovered, the coverage will be retroactively canceled. You may have to pay for costs incurred from the date the dual coverage began.

When certain life events or circumstances occur, you are entitled to make special enrollment updates. An example of a family status change could be adding or deleting a dependent due to birth, adoption, marriage, domestic partnership, divorce, or death. As well as gaining or losing an alternate non-CSU medical/dental plan. For additional information on family member eligibility, go to the CalPERS Family Status Change/Life Events page.

A Benefits Worksheet must be completed to add or delete a family member. This form must be returned to the Human Resources Benefits team via Adobe Sign. The effective date of all permissive transactions is the first of the month following the date the enrollment form is received in the Human Resources Office.

To add dependent(s) to your plan, you are required to provide social security numbers as well as additional applicable documentation such as: marriage certificate, Domestic Partnership Certification, birth certificate, adoption documents, divorce Decree, death certificate.

Mandatory transactions are additions or deletions from health enrollment due to requirement by law. The effective date of change is the first of the month following the event date.

Mandatory Transactions

Birth or adoption of a child
Death of a dependent
Dependent children reaching age 26
Divorce or termination of domestic partnership
Enrollment of spouse, registered domestic partner, or child dependent in a CalPERS sponsored health plan

Permissive Transactions

A child, spouse, or domestic partner who enters military service
A child who reaches age 18 or obtains non-CalPERS sponsored coverage
A spouse who moves out of the household
Addition of a spouse, domestic partner, or stepchild
Change in custody of a child

FlexCash* Plan
If you gain alternate non-CSU health and/or a non-CSU State sponsored dental coverage, you can cancel your medical or medical/dental and participate in the FlexCash plan to obtain cash in lieu of CSU coverage. The Benefits Worksheet and FlexCash form must be completed along with appropriate documents/information required and returned to the Human Resources Benefits team.

*FlexCash is taxable income.

Flexible Spending Plans
Family Status changes may allow an employee to enroll, cancel or change the deduction amounts in the Health Care Reimbursement Account (HCRA) and the Dependent Care Reimbursement Account (DCRA). If you have experienced a Family Status Change and need to enroll or make changes to your existing HCRA or DCRA please complete the HCRA/DCRA form.

Open Enrollment is your annual opportunity to review your benefits, your family's needs and your benefits package to match. Many life events can occur during the year that can affect the types of plans and amount of coverage you need. Think about the changes you and your family have experienced in the past year or anticipate in the coming year.

Open Enrollment Information

Health Insurance Portability and Accountability Act (HIPPA)

The Health Insurance Portability and Accountability Act (HIPAA) imposes numerous requirements on the use and disclosure of individual health information by employer health plans. These requirements apply to all employees and family members who are enrolled in a health, dental, vision or HealthCare Reimbursement Account (Flexible spending) plan. HIPAA protects the confidentiality between you and your health care provider.

In accordance with HIPAA, should you need HR/Benefits to assistance you with your health care claims, an Authorization to Use and/or Disclose Personal Health Plan Information Form must be completed and provided to HR/Benefits.

If you have questions regarding HIPAA., please contact the Campus Privacy Contact/HR Benefits Manager, at (559) 278-8237.