Benefit information is subject to change based on the collective bargaining process. This information reflects the most frequently asked questions and does not serve as an overview of the CSU Benefits Program. If there is a discrepancy between this information and the collective bargaining agreements, the official agreements will always govern.
Detailed benefit information is available at Benefits Unit website: www.csuchico.edu/hr/benefits/index.shtml
Important Note: If there is a discrepancy between this information and the official plan documents and contracts, the official documents will always govern.
To be eligible for plan coverage:
- An employee must be appointed at least half-time (equivalent to 7.5 weighted teaching units for academic year appointments) for more than six months, or:
- If employed in a R03 Lecturer or Coach Academic Year position, employee must be appointed for at least six (6) weighted teaching units for at least one semester.
- Qualifying appointments may be either permanent or temporary.
Once an employee has acquired eligibility and has enrolled in a plan, he/she may continue enrollment during subsequent continuous appointments of at least half-time regardless of the duration of new appointment.
Eligible employees must enroll in a plan(s) within 60 calendar days of employment (or reemployment, if there has been a break of service of more than 30 calendar days). The standard effective date for coverage is the first of the month following the receipt of the signed Benefit Enrollment/Change Worksheet in the Benefits Unit.
You may enroll yourself and eligible family members in the CSU health, dental and vision plans. Eligible family members include:
- Your spouse or registered domestic partner. (Former spouses and former domestic partners are not eligible.)
- Your children, adopted children, or stepchildren under age 26 (regardless of whether or not they are living with you)
- A child over age 26, who is incapable of self-support due to a mental or physical condition that existed prior to age 26, may be included when you first enroll. (Enrollment must be approved by CalPERS prior to enrollment and must be updated upon request.)
- Another person's child under age 26 may be eligible for coverage if a parent-child relationship exists.
Split Enrollments: Members who are married or in a registered domestic partnership and both work, or worked, for agencies in the CalPERS Health Program can enroll separately. If you and your spouse or domestic partner enroll separately, you must enroll all other family members, regardless of the relationship, under only one of you. Dependents cannot be split between parents. If split enrollments are found, they will be retroactively corrected. You will be responsible for all costs incurred from the date the split enrollment began.
A list of required supporting documentation is included on the back of the Benefit Enrollment/Change Worksheet.
You will need to review the current CSU, Chico Health Plan Benefits Overview and Dental Plan Benefits Overview. Detailed plan information is available at the CalPERS (www.calpers.ca.gov) and Delta dental (www.deltadentains.com/csu/) websites.
6. I intend to enroll in the Blue Shield Access+ HMO plan. How you I select a primary care physician (PCP)/medical group?
When you enroll in the Access+ HMO plan, Blue Shield will select a PCP for you and each of your dependents. You and your covered dependents have the option to select a different PCP/medical group. If you would like to change your PCP prior to your coverage effective date, you will need to call Member Services at (800) 334-5847, 7 a.m. to 7 p.m., Monday through Friday. After your coverage effective date, you may change your doctor online by logging in to www.blueshieldca.com, selecting the My Health Plan tab, and then choosing View My Plan Summary and Change Personal Physician. You can change doctors as often as you’d like, and the change will become effective the first day of the following month.
To find out if your current doctor is in the Access+ HMO network or to locate a new doctor, go to www.blueshieldca.com and click on Find a Provider Now. Under Select a Plan, choose CalPERS as your medical plan and CalPERS Access+ HMO as your sub-plan. Check Doctors, and then click Advanced Search to select HMO Personal Physicians in the Doctor Type or Specialty Field. Enter your ZIP code and click Find Now.
HEALTH PLAN: Yes, you should receive your card(s) approximately 10-15 business days after your benefits are recorded by the carrier. This card will also serve as your “prescription card”.
- Delta Dental PPO #4018 - No, you will not receive insurance cards. During your first appointment, you will need to provide your dentist with your Delta Dental PPO group number (#4018); your employer’s name (The California State University); your social security number (which must also be used by your dependents); your date of birth; and any other dental coverage you may have.
- DeltaCare USA HMO #02034 - You will receive an identification card and an Evidence of Coverage booklet describing your benefits. You can make an appointment once you have received confirmation of your enrollment. You may change contract dentists by notifying Delta Care USA by phone or in writing. DeltaCare USA must receive the DeltaCare USA enrollment materials and/or contract dentist change request by the 21st day of the month for coverage to be effective the 1st day of the following month.
VISION PLAN: No, you will not receive insurance cards. VSP network doctors contact VSP to verify your eligibility, plan coverage, and to obtain authorization for services. To find and select a network provider, you may visit www.vsp.com or call (800) 877-7195. Services provided by a non-VSP provider must be paid in full by you. For reimbursement coverage questions, please contact VSP or complete a VSP Out-of-Network Reimbursement form.
Supplemental Vision Plan Coverage: Video Display Terminal (VDT) coverage is offered only to employees whose job requires use of a Video Display Terminal for at least four hours per day. To receive this supplemental coverage, the VSP VDT Confirmation Form must be provided to your VSP NETWORK DOCTOR at the time of your appointment. You may download the VDT Confirmation Form from the Benefits Unit website (http://www.csuchico.edu/hr/_docs/BENE-VDTForm.pdf).
If you or any covered dependent need to fill a prescription prior to receiving your health insurance card, you will need to pay for the prescription in full (save your sales receipt) at a participating pharmacy. Once you receive your insurance card, you may submit a claim for reimbursement and your sales receipt to your health plan.
Life events such as marriage, registration of domestic partnership, birth or adoption of a child, divorce, termination of domestic partnership, or death of a family member will impact dependent benefit eligibility. You will need to contact the Benefits Unit immediately if any of these life events occur.
You can enroll, change health plans or add family members not currently enrolled during the annual open enrollment period (usually held mid-September through mid-October). The effective date of the enrollment/enrollment change(s) will be the following January 1.
Provided you have other non-CSU coverage, FlexCash is an optional benefit plan that allows you to waive CSU medical and/or dental insurance coverage in exchange for cash. The FlexCash monthly payment is treated as taxable income and will be subject to the same payroll taxes (i.e., federal, state, Social Security, Medicare) as regular salary. However, FlexCash will not be considered compensation for retirement purposes. The additional cash income will be reported as income on Form W-2 for the year you receive it.
In most cases, if you leave your job for reasons other than retirement, your benefit coverage will continue through the month you leave and the following month.
Yes. Consolidated Omnibus Budget Reconciliation Act (COBRA) allows you to continue benefit coverage for yourself and your dependents for a certain number of months, depending on the event. Your premium cannot exceed 102 percent of the group monthly premium rate. You must submit a COBRA Election Form within sixty (60) calendar days following notification of eligibility. The Benefits Unit will notify you automatically if you are eligible. Coverage must be continuous and you will be required to pay premiums from the date your benefit coverage ended.