Open Enrollment is a period annually in which employees are allowed to make changes to their medical, dental and vision plan coverage. Employees may enroll in benefits, change plans, remove dependents, or add eligible family members to their coverage. This is also a time to review and enroll in the CSU voluntary benefit plans.
Faculty and staff may also enroll or re-enroll for the Health Care Reimbursement Account (HCRA) and/or Dependent Care Reimbursement Account (DCRA) at this time. If you are currently enrolled in the HCRA and/or DCRA, and want to continue your coverage, you must re-enroll during the Open Enrollment period.
If your current medical and dental coverage meets your needs, and you are not enrolled in HCRA or DCRA, you do not need to take any action to continue your current coverage.
1. When is Open Enrollment?
All Open Enrollment Forms must be submitted to Human Resources between Monday, September 14th and Friday, October 9th, 2015.
2. What if I miss the deadline?
If you miss the deadline, you will need to wait until next year to change your coverage. However, if you have a qualifying life change (such as a birth, marriage, divorce or loss of coverage) that allows you to make a change mid-year, please contact Benefits administration. If you do not re-enroll in HCRA or DCRA, your coverage will end on December 31, 2015.
3. Am I eligible for University-provided Health Benefits?
You must be employed half time or more in a benefits eligible 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.
4. What's next?
Below you will find information on how plans have changed, how you can compare plan rates (between plans, and between 2015 and 2016). For each section (Medical, Dental, Vision, Flex ), read the information provided and visit the CalPERS Open Enrollment pages for additional tools and resources that will assist you in your decision making process.
Where can I find information on the Medical Plans?
- CalPERS Open Enrollment website
View the CalPERS Open Enrollment page and visit the "Our Health Plans Online". "Health Program Publications", and the “Health Plan Chooser”.
I. How have Medical Plans changed for 2016?
Highlights of the 2016 CalPERS health benefit changes are listed below. Please refer to the health plan's Evidence of Coverage (EOC) booklet for a complete explanation of the benefits covered, as well as limitations and exclusions that apply. For additional information on CalPERS health plans, please refer to the CalPERS open enrollment materials, or visit the CalPERS website at http://www.calpers.ca.gov.
1. Anthem Blue Cross and Blue Shield of California are introducing Welvie, an online tool that will help educate members and place more power in their hands when it comes to minimizing unnecessary and inappropriate surgeries.
2. Inclusion of Acupuncture and Chiropractic benefits for the PERS/Cares, Choice, and Select Plans and all three Medicare Supplemental plans Choice/Care/Select plans.
a. Acupuncture or Chiropractic services will provide twenty (20) annual visits (combined) for these services, regardless of medical necessity, at the standard office visit copay level ($15).
3. PERS Select is expanding into San Diego County.
4. Blue Shield of California will be enhancing the Prescription (Rx) benefit with a 90-day supply options allowing members the option to fill their prescriptions at select retail pharmacies. This includes CVS, CostCo, and Safeway pharmacies.
5. United Healthcare has expanded its service area to also encompass Kings, Marin and San Diego Counties. a. United Healthcare Rx to offer a 90-day supply option at select participating retail pharmacies at the mail order price.
6. Health Net SmartCare is expanding into Alameda, Contra Costa, Fresno, Kern, Kings, Napa, Sacramento, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, Tulare and Yolo Counties.
7. United Healthcare will be the single carrier for Medicare. This change will not affect the PERS Care/Choice/Select, or Kaiser Permanente Medicare plans. This plan will allow all plan members to receive care from any willing Medicare provider in California and across the country. It covers all of the care covered by Medicare Parts A, B and D and includes a comprehensive national network of contracted health care providers. United Healthcare Medicare Advantage (MA) Preferred Provider Organization (PPO) will be offered in all 58 counties in California and out of state.
a. United Healthcare Medicare will also offer HouseCalls and Silver Sneakers programs to members.
i. The HouseCalls program is an innovative home assessment program available nationally to qualified members of select United Healthcare Medicare Advantage plans at no cost to members. Helps to prevent complications by identifying gaps in care; increases adherence to care plan and care coordination and collaboration with member’s primary care physician.
ii. Silver Sneaker fitness program helps members with staying physically fit and active at no additional cost. The program allows members to choose a fitness center from more than 11,000 participating locations which offer classes, cardio equipment, resistance machines, free weights and heated pools (at certain locations). Many locations offer women-only fitness such as Curves nationwide.
II. Are Medical Plan Premiums changing for 2016?
Yes; some medical plan premiums will be affected - some are increasing and some are decreasing. This would be a good time to review your medical plan coverage and compare it to other options. View the Health Care Premium Comparison Chart to look at the different premium rates for 2016.
How have Dental Plans changed for 2016?
There are no changes.
Delta Dental (PPO) and DeltaCare USA continue to be employer-paid.
Where can I find information on the Dental Plans?
Dental Comparison Summaries:
DeltaCare USA Basic & Delta Dental Basic Plans: For eligible employees in the following categories: Unit 8, excluded E99, and Annuitants
DeltaCare USA Basic & Delta Dental Level I Enhanced Plans: For eligible employees in the following categories: Unit 10 and Unit 11 (Teaching Associates)
DeltaCare USA Enhanced & Delta Dental Level II Enhanced Plans: For eligible employees in the following categories: Units 1, 2, 3, 4, 5, 6, 7, 9 and C99, M98, M80 and FERP Annuitants
More information is available on the Delta Dental Website
CSU is pleased to continue providing CSU employees with a comprehensive vision plan for the 2016 plan year. The rates for the employer sponsored vision plan administered by Vision Service Provider (VSP) will remain the same for the 2016 plan year. The Plan will change to the Advantage Network from the VSP Regional Network Plan.
The VSP’s Advantage Program will bring employees much more value due to many additional discounts and access to promotional programs within VSP; such as many popular lens enhancements (progressive, anti-reflective, photochromic, scratch resistant coating, polycarbonate, plastic dyes and UV protection). CSU employees will also receive a 20% savings on amounts over allowances.
The current Vision Benefits Summary will be in effect through December 31, 2016. The monthly premiums will continue to be fully paid by CSU for the 2016 plan year.
Highlights of the CSU sponsored vision plan can be reviewed by visiting the CSU Systemwide Benefits Portal at: http://www.calstate.edu/hr/benefitsportal/. Please refer to the vision plan’s Evidence of Coverage (EOC) booklet for a complete explanation of the benefits covered, as well as limitations and exclusions that apply.
Can I be compensated if I waive CSUN coverage?
- If you are covered by a non-CSU health insurance plan, you may enroll in FlexCash. This benefit allows you to waive your CSU health plan and receive a cash payment of $128 (medical only); $12 (dental only); $140 (both medical and dental).
Further information can be found in the Flexcash Plan Brochure.
Are you missing an opportunity to put more money in your pocket?
With a Dependent Care Reimbursement Account (DCRA and/or Health Care Reimbursement Account (HCRA) you set aside a portion of your pay on a pre-tax basis to reimburse yourself for eligible expenses. If you are currently enrolled in the (DCRA) and/or (HCRA), and wish to continue participation in the plan(s), you are required to re-enroll annually during open enrollment.
For 2016, the maximum annual contribution for HCRA is $2,550 and remains at $5,000 for DCRA. The minimum for each plan is $20.00 per month.
Administrative fee remains $1.00 per month for each plan.
Flexible Spending Account Debit Card for HCRA Enrollees - The optional “FSA Benny Card” issued by ASIFlex, allows enrollees to pay for out-of-pocket medical expenses (i.e., health, dental, vision, etc.) as payment at Health Care Providers and at certain retail locations.
Start with the Benefits Open Enrollment Worksheet.As you work through the Open Enrollment Worksheet, you will be provided links to additional forms which may need to be completed and submitted to Human Resources along with your supporting documentation. You can also access these additional forms directly below.
1. Making a change to my Medical Plan:
In addition to completing the Benefits Open Enrollment Worksheet, access the Health Benefit Enrollment (HBD 12) Form.
Complete sections 1-4B, 6, 7, 9, 17, and 19 – 21 (You may ignore any codes in these sections).
Print and sign the form.
Print and complete the Declaration of Health Coverage (HBD 12-A) Form.
If you are switching medical plans, please make sure to list all dependents that you would like covered, whether or not they are included on your current plan.
2. Making a change to my Dental Plan:
Access the Dental Plan Enrollment Form. Complete Sections A, B, and D, and print. (You may ignore any codes in these sections).
If you are switching dental plans, please make sure to list any and all dependents that you would like covered, whether or not they are included on your current plan.
3. Making a change to my Vision Plan:
4. Making a change in Flexcash:
5. Making a change or enrolling/re-enrolling in a Dependent or Health Care Reimbursement Account:
CSU offers a variety of voluntary benefits beyond health and wellness that are important parts of managing your life. You pay for the premiums for these plans through payroll deductions. All of the following voluntary benefit plans, with the exception of the MetLaw Legal plan, allow employees to enroll throughout the year. The MetLaw Legal plan monthly premiums will increase to $21.70 from $19.70, effective January 1, 2016.
Additional information regarding these voluntary benefit plans can be found on the CSU Systemwide Benefits Portal at: www.calstate.edu/hr/benefitsportal/. Please contact the vendor directly to enroll.
MetLaw Legal Plan - This is your annual opportunity to enroll in the MetLaw Legal Plan for a low monthly premium of $21.70. The MetLaw Legal Plan offered by Hyatt Legal Plans, Inc., provides representation for many personal legal services for employees and their eligible dependents.