Open Enrollment
- Overview
- Forms and Deadlines
- 2012 Health Plan Costs
- Dependent Social Security Numbers Required
- Primary Care Physicians for HMO members
- CalPERS Health Plan Chooser
- Health Plan Changes
- New PPO Prescription Drug Administrator
- Dental Plans
- FlexCash Program
- Dependent Care (DCRA) & Health Care (HCRA) Reimbursement Account Changes
- Voluntary Benefit Plan Options
- Employees on a Leave of Absence
- Retiree Health Plan Changes
- COBRA Enrollees
- Tax Sheltered Annuities (TSA)
Overview
The Open Enrollment period for health, dental, FlexCash, Dependent/Health Care Reimbursement begins on October 10 and ends on November 4, 2011. However, forms regarding health, dental, vision, HCRA/ DCRA changes can be submitted early to HR Benefits beginning September 28, 2011.
During the Open Enrollment period, employees may:
- enroll in health, dental or Flexcash, if benefit eligible and not currently enrolled
- change plans
- add or delete eligible family members
- enroll or re-enroll in Flexible Spending Accounts (Health Care/Dependent Care Reimbursement accounts)
- add eligible dependents up to age 26
Forms and Deadlines
Changes made during Open Enrollment will be effective January 1, 2012. If you wish to make any changes, complete the appropriate form(s) found on the HR forms page. The specific forms to utilize will be:
- Health Plan - Open Enrollment Worksheet
- Dental Plan - Dental Enrollment Form
- Flexcash -Flexcash Enrollment Form ( if you are already enrolled in a CSU health or dental plan, you must fill out a health and/or dental form to terminate your enrollment before you can be enrolled in the Flexcash program)
- HCRA/ DCRA - Health Care/ Dependent Care Enrollment Form (participation in these plans must be renewed annually during Open Enrollment)
- HCRA "Benny" Debit Card Enrollment form - This 'opt in' benefit is optional for HCRA enrollees
To ensure timely processing, deliver the appropriate documents to Human Resources no later than November 4, 2011. Incomplete forms or forms received after the deadline will not be accepted.
Submit your forms early to HR Benefits!
Turning your forms in early facilitates the timely issuance of identification cards and premium payroll deduction changes. If you need further assistance, please call Kristi McMahon at ext. 4426 or Yvonne Chambers at ext. 3387.
Dependent Social Security Numbers Required
Social Security Numbers (SSNs) are required of any dependent enrolled in a CSU health, dental, and/or vision plan. If you elect coverage for one of your dependents during open enrollment, you will be required to provide a valid Social Security Number for that dependent. If a valid Social Security Number is not provided, your enrollment will not be processed.
Primary Care Physicians for HMO members
If you reside outside of Monterey County and are a member of an HMO, you can also change your primary care physician during open enrollment. If you wish to change physicians, you can do so by calling your HMO's customer service line. Please call the doctor's office to find out if the doctor is accepting new patients prior to calling your HMO.
CalPERS Health Plan Chooser
You should have received your CalPERS Open Enrollment packet in the mail, which includes your 
personalized Health Plan Statement, and a copy of Open Enrollment News. This statement includes personalized information for each member: the health plan in which the member is currently enrolled; the dependents enrolled in this plan; and the ZIP Code (home or work) currently used to determine the health plan eligibility.
CalPERS also offers a web-based "Health Plan Chooser" tool that can be accessed at: http://calpers.chooser.pbgh.org/wizard.asp. This tool allows members to view health plans in side-by-side comparisons, and rank them based on personal references. 2012 Health Plan and Open Enrollment information is available online at the CalPERS website: www.calpers.ca.gov.
Health Plan Costs
Pursuant to California Government Code 22871, the CSU Employer Health Contribution Rates for 2012 have increased and the new rates are:
All Employees (Except R06) Unit 6
Employee only $566 $571
Employee + one $1,074 $1,084
Employee + two or more $1,382 $1,402
Please view the 2012 Basic Rate Comparison chart to view the monthly premiums and employee out-of-pocket costs.
Health Plan Changes
The following offers an overview of the 2012 health plan changes for HMO and PPO plans as well as the PPO prescription drug administrator. More detailed information can be found by viewing the CalPERS webinar.
Blue Shield NetValue (Basic and Medicare) Plans:
- Expanding service area to include Contra Costa County, and withdrawing from Santa Barbara County.
- Adding providers in Los Angeles, Riverside, Orange, and San Bernardino Counties.
Blue Shield 65 Plus (Medicare) Plan:
- Expanding service area to include Imperial, San Joaquin, San Francisco, and Nevada Counties.
PERS Select/Choice/Care (Basic) Plans:
-
Expanding the Value Based Site of Care program; and establishing a payment threshold for three elective procedures. When member receive service at an outpatient hospital rather than an ambulatory surgery center the following thresholds apply:
- Arthroscopy - $6,000 limit
- Cataract Surgery - $2,000 limit
- Colonoscopy - $1,500 limit
PERS Select (Basic) Plan:
- Expanding service area to include Marin County.
Peace Officers Research Association of California (PORAC):
•Increasing the deductible from $50 to $100 for the Medicare Prescription Plan.
Note: Employees should refer to the Evidence of Coverage booklets for detailed information regarding coverage of medical services. For further information on 2011 health changes, visit the CalPERS website.
New Pharmacy Benefit Manager for PPO Members:
- CVS Caremark will now administer the prescription drug benefits. A Maintenance Choice Program will allow members to pick up a 90-day supply of medication directly from a CVS pharmacy at a time convenient to them. Members will pay their typical mail order co-pay for a prescription on the same day and be able to talk face-to-face with a pharmacist.
• The “Gaps in Care Plus” Medical Program will use an integrated medical and pharmaceutical approach to identify potential gaps and omissions in drug and medical therapy for participating members.
• Members will be able to save money by choosing “best choice” medications (generics and preferred brands) and 90-day supplies, where appropriate, in the “iBenefit” personalized mailing program.
General Pharmacy Benefit Highlights:
- Retail co-payments for band name drugs will increase by $5.
- Members may receive a 90-day supply of maintenance medication through mail order for the price of a 60-day retail supply.
- Members maintain access to brand name drugs when a Food & Drug Administration approved generic equivalent is available by paying the difference between the cost of the generic and the brand name drug. A brand co-payment applies when a prior authorization for the brand name drug is obtained due to medical necessity.
- Exclude discretionary lifestyle drugs from the $1,000 out-of-pocket maximum for mail order prescriptions.
- NOTE: In December 2011, new medical ID cards will be mailed to PPO members noting the CVS Caremark as the new prescription drug administrator. Please discard your old medical ID card. When visiting the pharmacy for the first time in 2012, please show your new ID card so they are aware the change.
- To aid in the transition from Medco to CVS Caremark, any prescriptions which have not expired and have at least one refill remaining will be transferred.
- Effective October, 1. 2011, members are encouraged to contact CVS Caremark to inquire about their current prescriptions, specifically if they transferred over and what the cost will be moving forward. CVS Caremark can be reached at 1-877-542-0284 or via the web at www.caremark.com/calpers effective October 1, 2011.
Dental Plans
There is no increase in dental premiums for the 2012 plan year. The premiums continue to be fully paid by the CSU.
The CSU continues to offer eligible employees two dental plan coverage types which include:
1. Delta Dental PPO - an indemnity plan
2. DeltaCare USA - a pre-paid dental health maintenance association
Please view the Dental Plan Summary for a side-by-side comparison.
Participating dentists in the Delta Dental Premier and PPO networks, applicable only to Delta Dental PPO, can be identified by accessing the Delta Dental Website at http://www.deltadentalins.com/csu/; or employees can request a list by contacting Delta Dental. Employees enrolled in DeltaCare USA will continue to select dentists from DeltaCare USA's exclusive list of providers, which is also provided at http://www.deltadentalins.com/csu/.
FlexCash Program
There is no change to the FlexCash plan. The benefit levels for FlexCash remain $128 per month for cash in lieu of medical coverage and $12 per month for cash in lieu of dental coverage; $140 per month for both. FlexCash is available to all CSU employees eligible for medical and dental coverage if they have other, non-CSU coverage. Employees planning to remain in FlexCash are not required to complete enrollment forms during open enrollment.
Lecturers and AY coaches who are appointed for at least six (6) weighted teaching units (0.4 time base) 0.4 time base for one semester may enroll in the FlexCash plan.
Dependent Care (DCRA) & Health Care (HCRA)Reimbursement Account Changes
The Dependent Care Reimbursement Account provides for the payment of dependent care expenses such as day care from your pre-tax income via a special tax-free account set up for this purpose. For more information, please peruse the DCRA brochure.
The HCRA program allows CSU employees to deduct pre-tax dollars that are placed into an account to cover eligible medical/dental/vision expenses that are not covered by insurance plans. For more information, please peruse the HCRA brochure.
As a reminder, the HCRA/DCRA plan year is January 1st - December 31st of each calendar year, and participants must submit claims no later than June 30th of the following year after the current plan year ends.
The maximum monthly contribution amount for each plan is $416.66 ($5,000 annually). Employees DO NOT need to be benefits eligible to participate in these programs. As a reminder, employees who wish to continue participation must re-enroll annually during open enrollment.
Enrollment forms must be received by HR Benefits no later than November 4th.
Changes to the HCRA/DCRA Plans
-
New HCRA Debit Card! The CSU is pleased to announce the implementation of the Flexible
Spending Plan (FS) debit card for HCRA enrollees, beginning in the 2012 plan year. The optional “FSA Benny Card” issued by ASIFlex, allows HCRA enrollees to pay for out-of-pocket medical expenses (i.e., health, dental, vision, etc.) when issued as payment at Health Care Providers and certain retail locations that have implemented an Inventory Control System, per IRS regulations. For more information about the debit card and how to enroll, please visit the HR News page.
Voluntary Benefit Plans
The following voluntary benefits are offered through payroll deductions:
| Plan | Vendor |
| Auto and Home Insurance | California Casualty |
| Critical Illness Plan | Aflac |
| MetLaw Legal Plan | Hyatt Legal Plan, Inc. |
|
Voluntary Accidental Death and Dismemberment Insurance |
The Standard |
| Voluntary Life Insurance | The Standard |
| Voluntary Long Term Disability | The Standard |
Additional information regarding these voluntary benefit plans and how to enroll can be found on the CSU Systemwide Benefits Portal. Please note that all of the above voluntary benefit plans, with the exception of the MetLaw Legal plan, allow employees to enroll throughout the year.
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. Employees that do not enroll in the plan during open enrollment, will not have another opportunity to enroll in the plan until next year’s open enrollment period.
Critical Illness Plan
During open enrollment this year, all CSU eligible employees will be provided with a final opportunity to enroll in the Aflac Critical Illness Plan with Guaranteed Issue - no health questions asked. Guaranteed Issue is available up to $20,000 for employee coverage and up to $10,000 for spouse/domestic partner coverage.
Voluntary Life Insurance
Effective January 1, 2012, the rates for the Voluntary Life Insurance plan offered by The Standard will decrease by an overall average of 15 percent.
Although Standard does not offer a formal open enrollment period for Voluntary Life Insurance, employees can enroll in the benefit at any time during employment. If an employee chooses to enroll after the first 60 days of hire or eligibility, the employee must submit a completed medical questionnaire along with the enrollment form.
Voluntary Long Term Disability Insurance
The Voluntary Long Term Disability Plan administered by The Standard provides loss of income protection (up to 60%) due to a qualified disability. The vendor offers two (2) different plan options which include a 30 or 90 day waiting period. Eligible employees can enroll in the benefit at any time duirng employment. If an employee chooses to enroll after the first sixty (60) days of hire or eligibility, the employee will be subject to Evidence of Insurability (EOI) requirements.
Auto and Home Insurance
The Auto and Home Insurance plan offered by California Casualty allows CSU eligible employees to obtain auto and home insurance policies at a discounted rate. The plan also has an identity theft component known as ID Defense. All policies are written for a 12-month period. Eligible employees can enroll in this benefit at any time during employment.
Employees on a Leave of Absence
Employees who are on a leave of absence and are unable to change plans or add dependents during Open Enrollment may do so within 60 days from the date they return to regular pay status.
Retiree Health Plan Changes
If you are a retiree, you should have received information in the mail about open enrollment from Oct. 10 - Nov. 4. Please call CalPERS at (888) CalPERS (225-7377) for assistance in making your open enrollment changes.
COBRA Enrollees
If you are covered under COBRA you may change health plans and/or add eligible dependents during Open Enrollment.
Tax Sheltered Annuities (TSA)
Currently, the following fund sponsors can offer loans and hardship withdrawals:
Current Fund Sponsors
- Fidelity - Hardship withdrawals and contract exchanges are available. Currently, Fidelity does not offer loans.
- ING Life and Annuity - Loans, hardship withdrawals and in-service contract exchanges are available.
- MetLife - Loans, hardship withdrawals and in-service contract exchanges are available.
- TIAA-Cref - Loans, hardship withdrawals and in-service contract exchanges are available.
- VALIC - Loans, hardship withdrawals and in-service contract exchanges are available.
Legacy Vendors
- Ameriprise Financial - Loans and hardship withdrawals are available.
- AXA Equitable - Loans and hardship withdrawals are available.
- Great American - Loans and hardship withdrawals are available.
- I-A Pacific (Industrial Alliance Pacific Life Insurance) - Loans and hardship withdrawals are available.
- ING Reliastar - Loans and hardship withdrawals are available.
- Jefferson National - Loans and hardship withdrawals are available.
- The Legend Group - Loans and hardship withdrawals are available.
- Life Insurance Company of the Southwest (LSW) - Loans and hardship withdrawals are available.
- Lincoln National - Loans and hardship withdrawals are available.
- Midland National - Loans and hardship withdrawals are available.
- Oppenheimer Funds - Loans and hardship withdrawals are available.
- Security Benefit - Loans and hardship withdrawals are available.
- Symetra - - Loans and hardship withdrawals are available.
- Transamerica - Loans and hardship withdrawals are available.
Please log on to Retirement Manager and download the appropriate certificate. This electronic process is a pre-authorization in lieu of the CSU plan administrator's signature of documents and eliminates the delay in processing your document. Once you print your certificate, attach it to the paperwork required by your company; no employer signature is required.
All other fund sponsors not mentioned above are frozen. As a result, many employees who have funds with these legacy vendors are unable to access those funds through a loan or hardship withdrawal. If you are with a vendor and cannot access a loan or hardship withdrawal, you have the option of making a contract exchange to current fund sponsor that offers loans or hardship withdrawals. You may be subject to surrender charges. Because the vendor is unable to meet the CSU requirements to offer loans/hardship withdrawals, you might be successful in requesting charges be waived. However, it you are over 59 1/2 , you may take a withdrawal.
100 Campus Center
