Medical Benefit Plans

Through its collective presence, the California State University system is pleased to be able to offer a selection of medical benefit plans to eligible employees. Employees may choose coverage through either an HMO (Health Maintenance Organization), or a PPO (Preferred Provider Organization).

If Eligible, your Coverage May Include:

  1. You, the employee

  2. Your spouse

  3. Registered Domestic Partner

  4. Your children and step-children under age 26 who depend on you for economic support and who have never been married. When adding a parent-child relationship, additional documentation may be required.

  5. Children under age 18, in your legal custody.

  6. Children over age 26 who became disabled before age 26 and who depend on you for economic support. 

Employee Premium contributions are based on the plan and the number of individuals covered.  The following chart outlines plan rates, employer (CSU) premium contribution amounts, and employee (you) premium contribution rates for 2022 versus 2021.

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HMO (Health Maintenance Organizations)

In these plans you must go to certain health care facilities and receive medical care from the doctors at those facilities.

  1. Blue Shield HMO

  2. Kaiser Permanente HMO

  3. Anthem Blue Cross HMO

  4. Health Net Salud y Mas HMO

  5. Health Net Smartcare HMO

  6. United HealthCare HMO


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PPO's (Preferred Provider Organizations)

In these plans you may receive medical care from the doctor of your choice and at the hospital of your choice. Certain doctors and hospitals, however, are part of the PPO network. If you use those doctors and hospitals, the PPO will pay a higher percentage of your bills.

  1. PERS Platinum (formerly PERS Care & PERS Choice)

  2. PERS Gold (formerly PERS Select)

  3. PORAC (Police Services Only) 

Health Care Benefits - Frequently Asked Questions

Take a moment to read through the following Frequently Asked Questions regarding medical, dental, and vision benefit coverage.

Your benefits begin the first of the month following your date of hire as long as the Benefits office received the medical enrollment form by the end of the month that you were hired. Example: Your date of hire was on September 2nd, if Benefits received your enrollment form by September 30th, you can enroll in medical benefits effective October 1st.

Note for Faculty: Faculty starting in the Fall are eligible for benefits effective October 1. Faculty starting in the Spring are eligible for benefits effective March 1st.

Your premium for your medical benefit plan is paid in advance of the pay period for which you receive the benefit. For example, health plan coverage for the month of August, 2014 will be deducted from your July, 2014 pay period warrant.

There are no premiums for dental and vision benefit coverage.

You have within 60 days after the marriage to add your spouse and/or stepchild(ren) to your health or dental coverage.  After 60 days, you can add them during the annual open enrollment period or through a "special enrollment" or "late enrollment" event. The latter applies to health coverage only.  You must provide a copy of your marriage certificate as well as your spouse's (and stepchild(ren)'s) social security number and sign the appropriate document(s) prior to the coverage going into effect.

You have 60 days from the date of birth or adoption placement (under age 26) to add a child to your medical and/or dental coverage.  After 60 days, you can add the child during the annual open enrollment period or through a "special enrollment" or "late enrollment" event. The latter applies to health coverage only.

Dependent children may be covered to age 26 as long as they are unmarried, have never been married, and are economically dependent upon the employee.  If disabled, special rules apply. Please contact the Office of Human Resources for information

If the child is under age 26, unmarried, living in a parent-child relationship and is economically dependent upon the employee he/she may be covered under the employee's health plan. 

A "parent-child" relationship is defined as one in which the employee has been given the authority and assumed responsibility for raising the child as their own. The natural parent cannot be living in the same household as the child.  If disabled, special rules apply.  The dependent must be enrolled within 60 days from the date of custody or during the annual open enrollment period.

After 60 days, "special enrollment" or "late enrollment" criteria may apply.  You must contact Human Resources, provide proof of custody and sign the required documents, including an "Affidavit of Eligibility."

No. Even if totally dependent on the employee, parents are not eligible for coverage.

Coverage is effective through the end of the following month in which you resign or the appointment ends.  If you work a few days into a pay period, the State Controller's Office will deduct any required premiums as long as there is enough net pay to cover that premium.

Yes. COBRA Continuation Coverage provides you the option of continuing your medical, dental and/or vision plans for up to 18 months (or longer in some cases).  You would be responsible for paying the entire premium amount to the carriers, plus a 2% administrative fee.  The provisions of COBRA also apply to dependents that lose coverage.  Please contact Office Of Human Resources for further information.

If you would like to continue your group benefits, you may do so by completing the COBRA election form. This form is automatically mailed to employees upon their separation from the University.

Dependent children are covered until the first day of the month following their 26th birthday. Example: Their birthday is September 3rd - their benefits will end on September 30th.

Yes, you may apply for COBRA for your dependent child. You may continue their insurance for a maximum of thirty-six (36) months.

No, you will make direct premium payments to the health carrier.

No, you may enroll in benefits prior to attending the New Employee Orientation.  Please complete your enrollment forms within 60 days of your hire date.

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