Initial Benefit Eligibility

There are three factors which determine your eligiblity for benefits: job classification/ employee group or bargaining unit, time base (e.g. full-time or part-time), and length of appointment.  Please peruse the initial benefit eligibility criteria for each CSUMB benefit.

Staff and Instructional Faculty (Tenure Track)

Employees appointed to work half time or more for six months and a day or faculty with a 12-month or one academic year appointment teaching a minimum of 7.5 weighted teaching units (WTUs) are eligible to enroll in CSUMB's health, dental, vision, Flex Cash, and flexible spending health and dependent care plans. Eligibility is subject to collective bargaining and policy. The earliest date benefits can be effective is the first of the month following the employee's hire date, depending on the type of benefit and when the enrollment forms are received by HR Benefits.

Lecturers and Coaches

Employees appointed for at least 6 weighted teaching units (WTUs) or a 0.4 timebase (FTE) for at least one semester are eligible to enroll in CSUMB's health, dental, vision, Flex Cash, and flexible spending health and dependent care plans. Eligibility is subject to collective bargaining and policy and generally begins October 1st for fall appointments and March 1st for spring appointments. For further information on specific benefits, enrollment deadlines, the academic year pay plan, and how to schedule a benefits orientation, please refer to the benefit eligibility letter.

For further information on eligibility requirements for faculty, please view the CSU Faculty Benefits Eligibility brochure.

Other Eligibility Factors

You may also be eligible for other benefit programs, such as employer-paid life and long-term disability insurance, depending on your employee category. For a list of benefit programs by employee category, please refer to the Benefits and Leave Programs Summary.

Employees already enrolled in a CALPERS health plan as a dependent are ineligible. If this coverage is terminated then the employee may enroll. Dual coverage is not allowed.

Please note that the California Public Employees Retirement System (CalPERS) laws govern eligibility for medical benefits. Special consultants, hourly and intermittent employees are not eligible for most benefit plans, including health, dental, and vision.

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Maintaining Benefit Eligibility

Upon establishing initial benefit eligibility, an employee remains eligible as long as he/she maintains at least a 0.5 time base for staff and 0.4 timebase for temporary faculty, regardless of the length of succeeding appointments. Appointments must be consecutive with no breaks in service.

Permitting Events

A permitting event is a life change that happens to the employee and/or their dependents, allowing the employee to make changes to their benefits.  Permitting events include but are not limited to:

  • Marriage/ Domestic Partnership
  • Separation/ Divorce
  • Birth/ Adoption/ Custody
  • Move
  • Dependents move out of household
  • Employee or dependents obtain other insurance
  • Loss of alternate insurance coverage

An Add/ Delete Worksheet and other applicable forms must be filled out and returned to HR Benefits within 60 days of the permitting event date.  Forms received after the 60-day deadline will be subject to a 90-day waiting period set forth by CalPERS.  Failure to report a permitting event within the specified time may result in delays and/or penalties.  

Should you have questions regarding a permitting event, please contact HR Benefits at x4426. 

Leaves of Absence/Breaks in Service (Direct Pay)

Your benefits may be affected when you take a leave of absence. Benefited employees who take a leave of absence without pay or are placed on a non-pay status for more than one pay period may elect to continue their benefit coverage by enrolling in the direct pay program. The direct pay program requires employees to self-pay the full monthly premium. Benefit coverage is not terminated for employees who are on a formal Family and Medical Leave, or Non-industrial and Industrial Disability Leave. Please contact HR for details and timelines prior to taking an unpaid leave of absence.

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Group Coverage Continuation (COBRA)

Enrolled employees who separate from CSUMB or whose appointment falls below eligibility status are also eligible for the Consolidated Omnibus Budget Reconciliation Act (COBRA) benefit. HR sends a written notice to every benefit-eligible employee and his/her family about COBRA rights as well as procedures for continued group coverage.

If your dependent(s) can no longer participate in a benefit plan due to a loss in eligibility, they may continue their plan coverage under COBRA. You and the dependent(s) affected will receive advance notice from CalPERS or the insurance carrier when benefits are to be terminated due to loss in eligibility. COBRA participants pay the full premium cost of continued group coverage.

Under federal law, the employee or family member has the responsibility to inform HR of a divorce, legal separation, termination of a child's dependency, or Social Security Disability determination within 60 days of the date of these events.

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Posted by Kristi McMahon on Apr 26, 2012 -