Benefits

Open Enrollment - 2014

The Open Enrollment period for Benefits Eligible Employees will take place from Monday, September 15, 2014 through Friday, October 10, 2014. 

Open Enrollment is an opportune time to evaluate your current benefits and review what makes the most sense for you and your family going forward. Any changes made during the Open Enrollment period will be effective January 1, 2015. During the Open Enrollment period, employees may enroll in a health plan, change health plans, remove or add eligible dependents, and enroll or re-enroll in the Health Care or Dependent Care Reimbursement Account plans.

Currently enrolled members will be mailed an Open Enrollment Packet in late August directly from CalPERS. Check back here in early September for additional important information on taking advantage of Open Enrollment.

To assist your review process, the Office of Human Resources will be hosting a Benefits and Wellness Fair on Tuesday, September 16, 2014 from 9:00 - 11:00 a.m. in the University Student Union (USU), Northridge Room.  Benefit plan representatives will be available to answer your questions. In addition, several of our campus partners will be present sharing information, products and services available on campus to support your wellbeing. Plan to join us!

VIEW THE 2014 - 2015 HEALTH BENEFITS COMPARISON CHART

What is Open Enrollment?

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 sign up 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 15th and Friday, October 10th, 2014.

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, 2014.

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 2014 and 2015).  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.

Medical Plans

Where can I find information on the Medical Plans?

View a Summary of the available plans

  1. View the CalPERS Open Enrollment page and visit the "Our Health Plans Online". "Health Program Publications", and the “Health Plan Chooser”.

  2. CalPERS Open Enrollment website

  3. You should also view individual video presentations designed to assist you in understanding each medical plan. 

  4. CalPERS Provider Video Presentations 

How have Medical Plans changed for 2015?

The Medical Plans choices remain the same with the following updates:  

  1. Removal of Sharp Medical Group from Blue Shield's NetValue Plan.United Healthcare has expanded its service area to also encompass San Joaquin and Aolano Counties.

    • Employees enrolled in Sharp through Blue Shield's NetValue Plan will receive a letter from the carrier.
  2. Blue Shield will no longer require the use of Centers of Excellence for knee/hip replacement.

  3. Blue Shield has eliminated the $250 outpatient hospital copay for upper endoscopies, colonoscopies, cataract surgery, and knee injections.

  4. Inclusion of Acupuncture and Chiropractic benefits for all HMO plans.

    • Plans that don't currently offer 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 ($ 15.00) .
  5. Adoption of High Performance Generic Step Therapy (HPGST) for HMO, EPO, and PPO plans.

    • High Performance Generic Step Therapy encourages the use of a preferred drug prior to the utilization of a non-preferred drug.  The preferred drug is FDA recommended and represents the most cost-effective drug for a given condition.  Per CalPERS, an established evidence-based protocol must be met before a non-preferred speciality drug will be covered.  It is important to note that the targeted brands in HPGST have generic alternatives within therapeutic classes and the dispensing of a generic alternative requires a new prescription from the prescriber.
  6. Implementation of Affordable Care Act (ACA) maximum out-of-pocket (MOOP) requirements.  For 2015, the ACA limits maximum out-of-pocket (MOOP) amounts for health plans to $6,600/$13,200 for individuals/families for both medical and pharmacy benefits combined.

    • CalPERS has made a correction to the out of pocket Maximum Calendar Year Co-pay and recently included supplemental information to the 2015 Health Benefit Summary booklet

    • Refer to page 17 of the CalPERS Health Plan Benefit Comparison – Basic Plans section. For the PPO Basic Plans, the amounts reflected in the Maximum Calendar Year Co-pay for an individual ($4,600) and family ($9,200) are incorrect. The accurate amounts are the same as 2014 which are $3,000 for an individual and $6,000 for a family for PERS Select and PERS Choice, and $2,000 for an individual and $4,000 for a family for PERSCare.

Are Medical Plan Premiums changing for 2015?

 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 2015.

 

Dental Plans

How have Dental Plans changed for 2015?

  1. There are no changes.
  2. Delta Dental (PPO) and DeltaCare USA continue to be employer-paid.

Where can I find information on the Dental Plans?

Dental Comparison Summaries:

  1. DeltaCare USA Basic & Delta Dental Basic Plans:  For eligible employees in the following categories: Unit 8, excluded E99, and Annuitants
  2. DeltaCare USA Basic & Delta Dental Level I Enhanced Plans:  For eligible employees in the following categories: Unit 10 and Unit 11 (Teaching Associates)
  3. 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

 

Vision Plan

How has the Vision Plan changed for 2015?

  1. There are no changes.
  2. VSP will continue to be employer-paid.

Where can I find information on the Vision Plan?

  1. More information on the Vision Plan is available online through the Benefits Portal.

 

Flexcash

Can I be compensated if I waive CSUN coverage?

  1. 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.

 

Flexible Spending Accounts: Dependent or Health Care Reimbursement Accounts

Are you missing an opportunity to put more money in your pocket?

  1. 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.
  2. For 2015, the maximum annual contribution for HCRA is $2,500 and remains at $5,000 for DCRA.
  3. Administrative fee remains $1.00 per month for each plan.
  4. 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. For more information about the “FSA Benny Card, use these links:        

If you wish to appeal a rejected HCRA and/or DCRA claim reimbursement, it must be filed within 60 days from the date the rejection was communicated by ASIFlex.

I'm Ready to Make a Change - Where Do I Start?

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:

 

Finalizing Changes to your Medical, Dental, and.or Vision Plans, and/or Enrolling in Flexcash & Flexible Spending Accounts (DCRA/HCRA).

  1. Complete the Open Enrollment Benefits Worksheet and the appropriate additional form(s).

  2. Submit a copy of your Marriage Certificate if adding your spouse.  Or, submit a copy of the Declaration of Domestic Partnership  if adding a domestic partner; for Domestic Partner tax implications.

  3. Submit a copy of a Birth Certificate if adding a dependent child (under 26 years of age). When adding a parent-child relationship, additional documentation may be required.

  4. Make sure to submit the Social Security Number for anyone you are adding to your plan.

  5. If enrolling in FlexCash, copy your insurance card showing proof of insurance, and include the copy with the completed forms.

  6. All forms are due by Friday, October 10, 2014

  7. Note: If you are concerned about forwarding sensitive personal information through the mail, we are available to receive your paperwork personally at the front desk, Office of Human Resources, University Hall Room 165.

  8. If you have questions about Open Enrollment, please send an email to: askHR@csun.edu. A representative will either respond to your email or call you.

Voluntary Benefit Plans

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. 

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.

Plan

Vendor

Website

Customer Service

Auto & Home Insurance

California Casualty

http://www.calcas.com/csu

886-68-0-5142

Critical Illness Plan

 Aflac

http://www.aflac.com/csu

800-433-3036

 MetLaw Legal Plan

Hyatt Legal Plans, Inc.

 http://www.metlife.com/mybenefits

800-438-6388

Voluntary Accident, Death &

Dismemberment Insurance

The Standard

 http://www.standard.com/mybenefits/csu

800-378-5745

Voluntary Life Insurance

The Standard

 http://www.standard.com/mybenefits/csu

800-378-5745 

Voluntary Long Term Disability

The Standard

 http://www.standard.com/mybenefits/csu

800-378-5745

MetLaw Legal Plan - This is your annual opportunity to enroll in the MetLaw Legal Plan for a low monthly premium of $19.70. The MetLaw Legal Plan offered by Hyatt Legal Plans, Inc., provides representation for many personal legal services for employees and their eligible dependents.