Health Benefits




Benefits Overview

Benefit information is shared during our monthly Onboarding for new staff and MPP employees. If you have questions or need additional information about benefits, please call (909) 537-5143 or X75143 or email Tiffany Angel Ruiz.


Benefits Eligibility

Employees qualified for benefits have 60 days from the date of their appointment to sign-up for benefits.

Staff, Teaching Associates & Tenured Faculty (or Tenure Track), and Management Personnel Plan (MPP) employees are eligible for benefits if appointed half-time or more for a period of more than six (6) months.

Lecturers and Coaches appointed based on the Academic Year (AY) calendar for two (2) or more consecutive quarters (one appointment letter) at .4 time base or greater are eligible for benefits. Coaches and Lecturers (Non-academic calendar year) are eligible for benefits if appointed half-time or more for a period of more than six (6) months.

Employees appointed on an hourly, intermittent basis do not qualify for benefits.

An enrolled employee may carryover coverage into a position with an appointment of less than 6 months as long as the time base is half-time or more (.4 for lecturers/ academic-year calendar), and there is no break in service in excess of a full pay period or more. The coverage will continue indefinitely when subsequent appointments of less than 6 months apply, as long as the time base does not fall below half time (.4 for lecturers/ academic-year calendar), there are no breaks of a full pay period or more, and the appointment is a salaried position.

Note: Eligibility for retirement plan membership in the California Public Employees' Retirement System differs from the eligibility for health benefits. See the Retirement Plans section of this site for more information.

Below are Benefit Summaries by Bargaining Unit (Union). They list all the benefits you may be eligible for as an employee belonging to that bargaining unit.

UAPD Unit 1 (Physicians)
CSUEU Units 2, 5, 7 & 9 (Support Services)
CFA Unit 3 (Faculty)
APC Unit 4 (Academic Support)
SETC Unit 6 (Skilled Crafts)
SUPA Unit 8 (Public Safety)
UAW Unit 11 (Teaching Associates)
MPP (Management)
C99 (Confidentials)

The 2017 Health Benefit Summary.


Loss of Eligibility

Employees and/or their dependents who lose eligibility for benefits may elect to temporarily continue the medical, dental and/or vision insurances through COBRA (Consolidated Omnibus Budget Reconciliation Act). Under the provisions of COBRA, the member pays the full premium cost plus a 2% administrative fee. Once established, the employee and/or dependent pays the premiums directly to the carrier.




Federal Law requires that employers sponsoring group health plans with more than 20 employees offer their employees and their families the opportunity for a temporary extension of health coverage (called "continuation coverage") at group rates, in certain instances, where coverage under the plan would otherwise end.

As an employee, if you are covered by a health, dental and/or vision plan, you have the right to choose this continuation coverage if you lose your group coverage because of a reduction in your hours of employment or the separation of your employment (for reasons other than gross misconduct on your part.)

If you are the spouse/dependent of an employee covered by the health, dental and/or vision plans, you have the right to choose continuation coverage for yourself if you lose group coverage under the health, dental, and/or vision plans for any of the following reasons:

  1. The death of your spouse,
  2. Separation of your spouse's employment (for reasons other than gross misconduct) or reduction in a spouse's hours of employment, or
  3. Divorce or legal separation from your spouse.

In the case of a dependent child of an employee, he/she has the right to continuation coverage due to the following reasons:

  1. The death of a parent,
  2. Termination or reduction in a parent's hours of employment,
  3. Parent's divorce or legal separation,
  4. The dependent ceases to be a "dependent child" (age 23, unless permanently disabled and unable to be self supporting)

Under the law, the employee or family member has the responsibility to inform the Human Resources Department of a divorce, legal separation, a child losing dependent status, or Social Security Disability determination within sixty (60) days of the event or the date on which coverage would be lost under the health, dental and/or vision plans, whichever is later.



Benefits Enrollment

New Enrollment

To enroll in benefits, newly eligible employees should complete a Benefits Enrollment Worksheet and submit it to the Human Resources Department within 60 days of the effective date of their qualifying appointment. If an employee submits the completed request by the end of the pay period in which their qualifying appointment begins, coverage may begin the first of the following month. The coverage effective date will be delayed if the Benefits Enrollment Worksheet, including all necessary enrollment information, is not submitted in a timely manner.

Note: If you miss the initial 60-day enrollment period, you can still enroll, however, your coverage will not be effective until the first of the month following a 90-day waiting period.

Benefit Enrollment Changes

Employees are allowed to make changes to their benefits during the year if a "major life event" occurs. Such events include:

  • marriage,
  • divorce,
  • birth or adoption of a child,
  • gaining or losing custody of an economically dependent child, and
  • and death of a family member.

Other events that warrant a change to the employee's benefits are:

  • a spouse moving out of the household,
  • a child turns 18 years of age, and
  • a family member enters the military or obtains other coverage.

To request a change in benefits due to a "major life event" a Benefit Change Worksheet must be completed and submitted to Human Resources within 60 days of the event.

Open Enrollment

An open enrollment period is scheduled each year to allow employees to make changes in their benefits. Currently, the open enrollment period is scheduled from September 12, 2016 through October 7, 2016 with changes effective January 1, 2017. During Open Enrollment, employees can make the following changes:

  • Enroll self and all eligible dependents
  • Change health or dental carriers
  • Enroll in the Flexcash Plan
  • Enroll/Re-enroll in the Dependent Care Reimbursement Account
  • Enroll/Re-enroll in the Health Care Reimbursement Account
  • Enroll/Opt out of the Tax Advantage Premium Plan

Open Enrollment Worksheet

2017 Medical Plan Rates

CalPERS Health Plan Information

Health Plan Summary for 2017



Health Plan Rate Changes

Effective January 1, 2017, rates for most health plans will change. Please refer to the attached rate sheet for monthly employee cost beginning with the December pay warrant.

Blue Shield Net Value HMO (no longer offered):

If you are enrolled in Blue Shield NetValue HMO, use the CalPERS Health Plan Search by zip code to view/choose health plans available in your area. If you do not make a change during Open Enrollment, you and your enrolled family members will be moved into the Blue Shield Access+ health plan.

NEW Pharmacy Benefits Manager:

Effective January 1, 2017, Optum RX will be the new pharmacy benefits manager for all of CalPERS’ health plans, with the exception of Kaiser and Blue Shield of California Health Maintenance Organization (HMO) plans. For additional information, please review CalPERS at This change should be seamless for all members currently receiving prescription coverage through Anthem HMO, HealthNet HMO, United Health Care HMO, Sharp HMO or CalPERS PPO health plans.

County Expansions/Contractions:

United Health Care is expanding within Riverside, San Bernardino and San Diego counties.

Diabetes Prevention:

All health plans will implement a diabetes prevention program that meets the Center for Disease Control and Prevention’s “Diabetes Prevention Recognition Standards and Operating Procedures”, at no additional cost to you. This benefit is designed to reach pre-diabetic plan members to prevent or reduce the onset of Type 2 diabetes.

The Standard Insurance Enhancement:

During this Open Enrollment period, The Standard Insurance will allow employees the OPPORTUNITY to enroll or increase Supplemental Life insurance up to $100,000 (employee only) coverage without providing Evidence of Insurability.

Prior declined employees will need to provide satisfactory Evidence of Insurability.

AFLAC Critical Care Illness Insurance:

During this Open Enrollment AFLAC will allow employees the OPPORTUNITY to enroll or increase Group Critical Illness Insurance with coverage up to $20,000 for employee only, and $10,000 of coverage for their spouse/domestic partner without providing Evidence of Insurability.


Family Members Eligible to Enroll

Eligible employees may enroll themselves only, or themselves and all eligible family members (who are not otherwise enrolled as an employee, annuitant or dependent under the Public Employees' Medical and Hospital Care Act-PEMHCA).

The following family members are eligible to be covered by an employee's plan:

  • Spouse
  • Registered Domestic Partner - Same sex if both are over the age of 18 or opposite sex if at least one is over the age of 62.
  • Note: You must include your Spouse or Domestic Partner's Social Security Number on the Benefits Enrollment Worksheet. You must also provide Human Resources with your original Marriage Certificate or Declaration of Domestic Partnership
  • Children (Natural, adopted or stepchildren under age 26 whether or not they may be living with the employee, married or eligible for coverage through alternative enrollment or availability of other employer-sponsored coverage).
    Note: The spouse of an employee's child and their children are not eligible.
  • A child other than the employee's natural, adopted or step-child, who is living with the employee in a parent-child relationship and of whom the employee has been granted custody or joint custody. Also eligible is a grandchild living in the employee's household in absence of their natural, adopted, or step parent.
    Note: Completion of an Affidavit of Eligibility is required for the addition of a child other than the employee's natural, adopted or stepchild. If the employee's existing enrollment includes a child under this eligibility criteria and the employee requests to add an additional child under this provision, then an Affidavit will be required for the new child, and an updated Affidavit for each existing child currently enrolled.
  • An eligible child over age 26 who is incapable of self-support because of a mental or physical disability that existed prio



Medical Insurance Plans

Medical coverage for eligible CSU employees is provided through the California Public Employees' Retirement System (CalPERS) and is governed by the provisions of the Public Employees' Medical and Hospital Care Act (PEMHCA).

Before making your selection, you might want to:

Affordable Care Act (ACA)

CSU employees working an average of 130 hours or more per month may be eligible to enroll in a medical plan or in FlexCash, if enrolled in a qualifying medical plan through a family member.

If you do not have access to medical coverage you may be eligible for coverage under the Covered California marketplace. Covered California offers coverage to individuals that are not eligible for coverage through the CSU, another employer or the government program.

Covered CA is the new online marketplace for affordable, quality health insurance. At you can:

  • Compare health insurance plans
  • Determine how much financial assistance you may receive
  • Learn about your options, benefits and costs

You and your family may get financial assistance in paying the costs of insurance coverage. Covered California will also enable consumers to compare and choose health coverage that best fits their needs and budget. All will get a choice of insurance companies and a choice of benefits.

Under the new law, many families will be eligible for financial assistance in purchasing insurance. That assistance will be provided on a sliding scale, giving more support for those who earn less.

But to receive that assistance you must purchase your insurance through Covered California.

For information about Covered California, to learn if you may be eligible for financial assistance, and for enrollment information, visit Covered CA.

Health Maintenance Organizations (HMO's)

HMOs offer a range of health benefits including preventative care. Employees select a primary care physician who coordinates all care including referral to specialists. If you go outside the HMO's provider network without a referral, you may be responsible for the total cost of the services.

Preferred Provider Organizations (PPO's)

PERS Choice, PERS Care and PERS Select

Plan Details: List of doctors/hospitals in the PPO network. Non-network providers may be used, but co-payments will be higher. Members may select a primary care provider and specialists without referral. Annual deductibles must be met before some benefits apply.



FlexCash Program

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

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

FlexCash Basics

  • Proof of other non-CSU coverage must be provided on the Benefits Enrollment Worksheet.
  • Coverage as a dependent of another CSU employee causes ineligibility.
  • 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.

FlexCash Brochure



Dental Insurance Plans

The CSU offers two Dental Plans for eligible employees and their eligible dependents.

Delta Dental PPO of California (Comprehensive Dental Plan)

Group #: 4018

  • 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. This plan has a deductible.
  • You may read the Evidence of Delta Dental PPO Coverage for information on covered benefits.
  • You will need to complete and submit your own dental claim form for services provided by a non-Delta dentist.

DeltaCare USA (Dental HMO)

Group #: 2M77



Vision Plan

All eligible employees and their eligible dependents are automatically enrolled in the Vision Services Plan (VSP).

Group Plan Number #: 30059426 (effective January 1, 2016)

Vision Service Plan (VSP) provides the administration of vision benefits and claims on behalf of the employer-paid California State University (CSU) Vision Plan.  All eligible employees are automatically enrolled and may add their dependents either as a newly benefit eligible employee or during Open Enrollment.

Under VSP, the frequency of benefits is based on a calendar year perspective. For example, if an employee has an eye exam in February 2016, he/she will be eligible for another eye exam on January 1, 2017, or thereafter.

Who is VSP?

Founded in 1955, VSP is dedicated solely to providing eyecare wellness benefits through an exclusive network of independent eye doctors. These independent eye doctors are an important component of VSP’s focus on eye health, diseases and conditions, and are grouped in the VSP Select Network, which has approximately 17,000 providers.

Vision Plan Benefits

Under VSP, the following vision benefits are available to eligible CSU employees:

  • In-network frame allowance - $95.00;
  • Out-of-network frame allowance - $60.00;
  • In-network contact lens allowance - $120.00;
  • Polycarbonate lenses are covered for dependent children in-network up to age 23, instead of age 12; and
  • Discounts of approximately 15% for laser correction surgery are available

For more detailed information about what the plan covers:

VSP Benefit Summary

VSP Active EOC

VSP Online Access

Employees can complete an online member registration enrollment to create a user identification (ID) and password, for the purpose of viewing his/her vision benefits at​.  VSP will require the employee’s SSN to verify eligibility.

Additional information:

VSP Out of Network Form

Tru Hearing Aid Discount Program


Tax Advantage Premium Plan (TAPP)

The Tax Advantage Premium Plan (TAPP) allows employees to have required health plan premiums withheld from their paychecks on a pre-tax basis, reducing federal and state income and Social Security/Medicare taxes.


All CSU employees enrolled in a CalPERS health plan, and who have health care contributions withheld from their paycheck, are eligible to participate.


Eligible employees are automatically enrolled in the program unless non-participation is requested at the time of enrollment. There is a 17 cent/month service charge which is automatically collected by the State Controller's Office through a payroll deduction.

TAPP Brochure



Health Care Reimbursement Account (HCRA)

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

  • Employees may contribute between $20 to $212.50 each month ($2,550 maximum per year) to personal account.
  • Contributions are deducted from the employee's pay before federal, state and Social Security (FICA) taxes.
  • Employee must complete an Open Enrollment form during the annual Open Enrollment period to continue participation for the following calendar year. The contribution amount can be changed at that time.

Reimbursement Information:



Dependent Care Reimbursement Account (DCRA)

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

  • The care must be necessary for the employee (and spouse, if married) to work.
  • Contributions of $20 to $416.66 each month ($5,000 maximum per year) are deducted from the employee's paycheck and are held in the employee's personal account.
  • Contributions are deducted from pay before Federal, State and Social Security (FICA) taxes.
  • Employees must complete an Open Enrollment form during the annual Open Enrollment period to continue participation for the following calendar year. The contribution amount can be changed at that time.)

Reimbursement Information:

  • File claim for reimbursement by completing HCRA / DCRA claim form, attaching documentation and mailing to:
    P.O. Box 6044
    Columbia, MO 65205-6044 or fax to: (573) 874-0425
  • For expenses to be eligible:
    • Dependent must be a child under age 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.


Health Insurance Portability and Accountability Act (HIPAA)

The Health Insurance Portability and Accountability Act (HIPAA) protects the enrollment and policies for employees and family members who are eligible to enroll in a CalPERS-sponsored health plan.

HIPAA also protects the confidentiality between you and your health care provider. In accordance with HIPAA, should you need a CSUSB Benefits Coordinator to assist you with your health care claims, an Authorization to Use and/or Disclose Personal Health Plan Information Form is required.
Additional Information: