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Benefits

Health Benefits

Health Maintenance Organizations (HMO)

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.

Preferred Provider Organizations (PPO)

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.

 

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.

Delta Dental (PPO) 800-626-3108

Delta Dental plan is a group dental plan that allows you to choose any dentist. The benefits described in the Summary Brochure are guaranteed only when services are provided from a Delta member dentist. Your collective bargaining unit determines your level of dental coverage.

  • Enrollees may select a dentist of their choice.
  • Members may choose a dentist in the Delta Premier or Delta PPO network and pay less.
  • The plan sets the limits it pays for each specific type of dental treatment. Members are responsible for paying any remaining balance.
  • You may read the Evidence of Coverage for information on covered benefits.
  • You will need to complete and submit your own claim forms for services provided by a non-Delta dentist.

Delta Care USA (HMO) 844-519-8751

DeltaCare USA is a prepaid plan.  Many of the services are covered at no cost to the employee while some services require a co-payment. Your collective bargaining unit determines your level of dental coverage.

  • Enrollees and their eligible dependents are required to use a dentist who is a contracted DeltaCare provider.
  • Most basic services are covered at no cost. Please consult with your dentist the cost of the services to be rendered and if the services are covered in full.
  • View the Evidence of Coverage for information on covered benefits. DeltaCare® USA website.
  • When enrolling in DeltaCare USA you must choose a provider from their list. You can view the  Directory of Dentists  to find a provider. Similar to a HMO, you will receive a membership card and evidence of coverage that describes the covered benefits. The membership card will have the telephone number and address of your dentist. If you wish to change your dentist, you can do so by contacting DeltaCare USA at 844-519-8751.


Dental Plan Summary by employee category

 

Delta Dental (PPO) (800) 626-3108

Benefit Highlights Enhanced PPO

Be Network Savvy

SmileWay Wellness

Delta Care USA (HMO) (844) 519-8751

Benefit Highlights Enhanced HMO

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. Click here to review the comparison.

The Basic vision plan includes:

  • 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.

The Premier Vision plan includes:

  • 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.

Accessing Benefits

  • Claim form is not required when using standard in-network benefits.
  • For employees eligible for the Video Display Terminal benefit, print the VDT Claim Form and present this to the VSP Select Network doctor or non-VSP provider.
  • Services provided by a non-VSP provider must be paid in full by the employee. For reimbursement, complete a VSP Out-of-Network Reimbursement form.

Additional Information

News & Updates

Collection of Dependent Social Security Numbers

Forms

Vision Basic Plan and Vision Premier Comparison 

Vision Reimbursement and VSP Computer Vision Glasses Forms

FlexCash


Employees who are eligible for medical/dental insurance and have other non-CSU coverage can elect to waive CSU coverage in exchange for a monthly cash payment:

  • Medical and dental: $140
  • Medical only: $128
  • Dental only: $12


Employee FlexCash Basics


Must certify that they have alternative non-CSU medical and/or non-CSU or state sponsored dental coverage.
Provide proof of other non-CSU coverage.
Not eligible to participate if covered as the dependent of another CSU employee.
FlexCash payment is treated as taxable income and is subject to payroll taxes.
Eligible employees have 60 calendar days commencing with their appointment date to enroll in the FlexCash plan.

Submitting FlexCash Form & Supporting Documentation

Forms and Publications

If you are a new hire or have gained coverage within the past 60 days and would like to enroll in FlexCash submit the following:
- FlexCash Enrollment Form
- Proof of other Insurance
- Benefits Enrollment Worksheet (New Hire)
- Family Status Change Worksheet (Currently enrolled)

If you have lost coverage within the past 60 days and would like to cancel your FlexCash submit the following:
- FlexCash Enrollment Form
- Proof of loss of other insurance
- Benefits Enrollment Worksheet

 

Health Care Reimbursement Account (HCRA)

This voluntary benefit plan offers eligible employees the ability to pay for eligible out-of-pocket health care expenses with pre-tax dollars:

Enrollment Information

  • Enroll by completing Enrollment Form and returning to Human Resources within 60 days of hire or eligibility. The Effective date will be determined by the date the form is submitted to Human Resources within the 60 day period. 
  • Employee may contribute between $20 to $254.16 each month ($3,050 maximum per year) in 2024.
  • Contributions are deducted from pay before federal, state and Social Security (FICA) taxes.
  • Employee must re-enroll during the annual open enrollment period during the month of September to participate during following calendar year. Contribution amount may be changed at that time.
  • Once the plan year has begun, you cannot make changes (increase, decrease, or stop deduction) in your authorization unless there has been a change in your status as defined by the Internal Revenue Services (IRS).  Refer to HCRA Brochure.

Submitting a Claim Form

  • File claim for reimbursement by completing Claim Form, attaching documentation and mailing to ASI, P.O. Box 6044, Columbia, MO 65205-6044 or fax to (573) 874-0425.
  • Expenses eligible to be reimbursed must be:
    • medically necessary,
    • incurred by an employee, employee’s spouse, or eligible dependents (including domestic partner), and
    • not covered by the employee’s own or another insurance plan.
  • Refer to HCRA Brochure for a list of reimbursable and non-reimbursable expenses.
  • Any money left in employee’s account after expenses have been paid for the year is forfeited.

Dependent Care Reimbursement Account (DCRA)

This voluntary benefit plan offers eligible employees the ability to pay for eligible out-of-pocket expenses for dependent care with pre-tax dollars if the care is required in order for the employee (and spouse, if married) to work.

Enrollment Information

  • Complete Enrollment Form and return to Human Resources within 60 days of hire or eligibility. The Effective date will be determined by the date the form is submitted to Human Resources within the 60 day period. 
  • Employee may contribute between $20 to $416.66 each month ($5,000 maximum per year) in 2024.
  • Deducted from pay before federal, state and Social Security (FICA) taxes.
  • Employee must re-enroll during the annual open enrollment period during the month of September to participate during following calendar year. Contribution amount may be changed at that time.
  • Once the plan year has begun, you cannot make changes (increase, decrease, or stop deduction) in your authorization unless there has been a change in your status as defined by the Internal Revenue Services (IRS).  Refer to DCRA Brochure.

Submitting a Claim Form

  • File claim for reimbursement by completing Claim Form, attaching documentation and mailing to ASI, P.O. Box 6044, Columbia, MO 65205-6044 or fax to (573) 874-0425.
  • For expenses to be eligible:
    • Dependent must be child under 13 for whom employee or spouse is entitled to claim dependent status on income tax return, or spouse who is unable to care for him/herself, or a financially dependent member of employee’s household; and
    • Care must be required in order for employee to be gainfully employed and, if married, spouse also must be employed or actively looking for work.
  • Refer to DCRA Brochure for additional eligibility rules.
  • Any money left in employee’s account after expenses have been paid for the year is forfeited.

Flexible Spending Plan Information

ASI (website)

Enrollment/Change Form

DCRA Brochure

HCRA Brochure

​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 yo​u to choose a plan that best suits your need​s.​

CSU Benefits Overview

An array of health plans that include prescription drug coverage
Your choice of dental plans
Vision coverage
Income protection benefits including life insurance and disability
Retirement plan through CalPERS
Tuition waiver for employees and dependents
FlexCash (in lieu of health/dental)
Employee Assistance Programs
And more

Additional Benefits & Services

Accident Insurance
Auto/Homeowners Insurance
CalPERS Long Term Care (Enrollment is temporarily suspended)
Critical illness supplemental insurance
Landed (A shared equity down payment program when purchasing a home)
​​​Pet Insurance
Pre-paid legal services
Pre-tax health and dependent care reimbursement accounts
Pre-tax parking deduction plan
Scholarshare (529 plan)
Voluntary Retirement Savings Plans (403(b), 457, 401(k))

Split Enrollments

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.

Dual Coverage

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. 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.

New Hire Enrollment


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 in 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.

Adding or deleting eligible family members may be done during a qualifying Family Status change or during the open enrollment period. The medical plans are administered by the California Public Employees Retirement System (CalPERS). No dual enrollment or split enrollments are allowed.

Health/Dental/Vision Plan Enrollment
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. The effective date of enrollment is the first of the following month that the Benefit Worksheet is received in the Human Resources Office.

Forms and Publications 2023 Health Rates New Hire Documents

 

Family Status Change

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. 

Family Status Change Information

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. 

Dependent(s) Required Documents: Social Security Numbers and additional documentation:  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 include events such as:

  • 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 are additions or deletions of dependents from an existing enrollment due to a voluntary request by the enrolled member.  The eligibility date is within 60 days of the event date.  If the Benefits Worksheet received date is beyond the 60th day, the effective date is the first day of the month following a 90-day waiting period from the Human Resources Benefits team received date

These transactions include:

  • 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 form and FlexCash form (cancel or enroll) must be completed along with appropriate documents/information required and returned to the Human Resources Benefits team.   

FlexCash is taxable income.

  • Waive Medical and Dental $140
  • Waive Medical Only $128
  • Waive Dental Only $12

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. 

Forms & Publications

Open Enrollment

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) 278-5336.