Medical, Dental & Vision Benefits

 


Tax Advantage Premium Plan (TAPP)

Employees electing health coverage through the CSU can also elect to participate in the Tax Advantage Premium Plan (TAPP), which allows them to pay the employee part of the premium with pre-tax dollars. This will reduce the amount of federal, state and FICA taxes. There is an administrative charge of $.17 per month to participate.

Employees can elect to decline TAPP by completing an election form to disenroll.

 


Health Plan Enrollment

The following health plans are available to CSU employees:

Health Maintenance Organizations (HMOs)

Blue Shield - an individual practice plan where contracted doctors and hospitals provide all services. For more information, consult the Evidence of Coverage Booklet.

Blue Shield Net Value - Same level of benefits as Blue Shield Access+ at a lower monthly premium cost and with a smaller network of medical groups. For more information, consult the Evidence of Coverage Booklet.

NOTE: Currently, Blue Shield NetValue is available in 17 California counties. To find out if Blue Shield NetValue is available in your county, use the CalPERS Health Plan Search by Zip Code feature on the CalPERS website.

Kaiser - a clinic/hospital-based plan where one specific clinic or hospital provides the services. For more information, consult the Evidence of Coverage Booklet.

  •  


Preferred Provider Organizations (PPO)

PERSChoice, PERSCare

  • List of doctors/hospitals in the PPO network. Find an in-network provider > select “Find a Doctor” > select “Visitor Search” > for “Plan Type” select “Large Group” > for “Select a Plan” choose “Plan is Blue Cross PPO (Prudent Buyer)” > make your selection for “Select A Provider Type”
  • Non-network providers may be used, but co-payments will be higher.
  • Members may select primary care provider and specialists without referral.
  • Annual deductibles must be met before some benefits apply.

PERS Select (administered by Blue Cross of California).

PERS Select allows you to manage your own care. You can see a specialist without a referral and can change physicians whenever you wish. Benefits are paid at the highest level when the provider you choose is a preferred provider, a provider that participates in the Blue Cross Select PPO network.

NOTE: Currently, PERS Select is available in 54 California counties. To find out if PERS Select is available in your county, use the CalPERS Health Plan Search by Zip Code feature on the CalPERS website.

Additional Information:

Premiums

Monthly plan premium costs are shared by the CSU and the employee. Employee contribution rates vary depending on the plan selected and the number of dependents enrolled.

Choosing a Plan

Need help choosing a medical plan? Try the CalPERS Health Plan Chooser.

To Enroll

Complete Health Benefits Enrollment form and Declaration of Health Coverage, and return both forms to the Benefits Unit in Human Resources.

 


Dental Plan Enrollment

There are two dental plans available to CSU employees. The premiums for the dental plans are paid entirely by the CSU, but both plans vary in benefits and copayments. It is important to evaluate each plan based on personal and family needs.

 

The two dental plans available are:

DeltaCare USA (HMO) - A Managed Care plan. Employees must select a dentist from within PMI's network of dentists who have contracted for services at no cost or at a set amount per procedure. Family members may choose a different dentist in the network.

Delta Dental -Comprehensive Dental Program (PPO) - An indemnity plan. This fee-for-service plan allows employees to select their own dentist. This plan has a deductible. You may select dentists from the Delta Dental Premier or Delta Dental PPO network for additional savings.

Additional Information:

  • Delta Dental

To Enroll

Complete the Dental Enrollment form and return to the Benefits Unit in Human Resources.

 


Vision Plan Enrollment

San Francisco State University provides a vision care benefit to eligible employees. The State pays the premium for the employee and any dependents. The provider is Vision Service Plan (VSP).

The vision benefit allows one comprehensive calendar year examination every 12 months and one set of lenses and one frame, or contact lenses, every other calendar year. Click here for more information regarding VSP. There is a $10 copayment for this benefit.

 

Additional Information:

If you choose to use a non-VSP provider, an itemized receipt along with a completed VSP Out-of-Network Reimbursement form mailed to the following address:

VSP 
PO Box 385018 
Birmingham, AL 35238-0518

 

VSP will make payment directly to you based on the out-of-network allowances.

 


FlexCash Plan

Employees who have non-CSU health and/or dental coverage can elect to participate in the FlexCash plan to obtain cash in lieu of CSU coverage. The money is taxed.

Waive Medical and Dental $140
Waive Medical Only $128
Waive Dental Only $ 12

Additional Information:

 


COBRA Enrollment

Employees who lose eligibility for medical, dental, and vision plans due to a reduction in work hours or termination of employment are eligible to continue benefit coverage under COBRA for a maximum of eighteen months. This benefit extends to dependents covered by the employee's medical, dental and vision plans. When dependent children turn 26, they are eligible for a maximum of up to 36 months of continuation coverage.

If continuation is elected, employees and/or dependents will be required to pay the full premium plus a 2% administrative fee. The coverage will end prior to the 18-month maximum if the premiums are not paid in a timely manner, or if the enrollee is covered under another health plan, or becomes entitled to Medicare.

Click here for a detailed description of COBRA, or contact the Benefits Service Unit at (415) 338-1873 for eligibility and qualifying events.

Additional Information:

2017 COBRA Rates PDF

 


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 an SFSU benefits coordinator to assist you with your health care claims, an Authorization to Use and/or Disclose Personal Health Plan Information Form is required.


Medicaid and the State Children's Health Insurance Program (SCHIP/CHIP)* Offer Free or Low-Cost Health Coverage to Children and Families

If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid* or CHIP* programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid* or CHIP* and you live in a State listed below, you can contact your State Medicaid* or CHIP* office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid* or CHIP,* and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid* or CHIP* office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

If you and/or your dependents enroll in State Medicaid* or CHIP*, but subsequently lose eligibility, you and your dependents can be re-enrolled in the employer?s health plan. If you (or your dependent(s)) are already enrolled in your employer?s health plan, but become eligible for State Medicaid* or CHIP*, you have the right to dis-enroll yourself and/or your dependent(s) from the employer?s health plan**. These special enrollment/disenrollment requests must be submitted to the Benefits Office within 60 days after you or your dependent(s) is terminated from, or determined to be eligible for such assistance.

If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States (State Office Locations) is current as of November 3, 2010. You should contact your State for further information on eligibility.

Medicaid and the State Children?s Health Insurance Program (SCHIP/CHIP)* Offer Free or Low-Cost Health Coverage to Children and Families.

Additional Information: