As an employee of the California State University (CSU), you have a comprehensive program of health benefits including medical, dental, vision, flexible benefits programs and more available to you and, in many instances, your family.
Below please find information to help you understand and navigate the rules, guidelines and deadlines governing the CSU Benefits Program.
Eligible Employees
To be eligible for medical 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 an R03 Lecturer or Coach Academic Year position, employee must be appointed for at least six (6) weighted teaching units for at least one semester, or two or more consecutive quarter terms.
- 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 the new appointment.
An employee who does not meet the eligibility criteria above may be eligible for medical coverage or FlexCash under the Affordability Care Act (ACA) if any of the following criteria is met:
- Works an average of 130 hours per month based on an annual review of computed time-base or reported hours during a 12-month measurement period, or
- Appointed with at least a .75 time-base regardless of length of appointment (duration) or initially hired to work at least 130 hours per month.
Non-Eligible Employees
Employees excluded from medical benefits include:
- Intermittent employees
- Student assistants
- Graduate assistants
- Faculty employed solely to teach summer session, extension, or intersession
- Any employee paid from funds not controlled by the California State University or from revolving or similar funds from which a regular California State University premium payment cannot be made.
Eligible Dependents
Eligible dependents of an eligible employee include:
- Spouse (unless legally separated or divorced)
- Domestic partner (registered through the Secretary of State process), and
- Dependent children from birth to the end of the month in which the child reaches 26. A dependent child includes a stepchild, a natural born child, or a child living with the employee in a parent-child relationship who is economically dependent upon the employee.
Dependents become eligible coincident with the Eligible Employee or upon attainment of dependent status. Newborn infants are eligible for medical coverage from and after the moment of birth. Adopted children are eligible for medical coverage from and after the moment the child is placed in the physical custody of the Eligible Employee for adoption.
Domestic Partners
State law allows, under specific conditions, for persons in the State of California to register non-marital relationships with the Secretary of State. This law also will recognize same-sex and opposite sex legal unions, other than marriage, validly formed in another jurisdiction that is substantially equivalent to a registered domestic partnership in California. Consequently, CalPERS will require information specific to the domestic partnership to determine whether or not a particular state/jurisdiction law will be recognized. Having obtained registration of the relationship, the law allows the registered individuals to obtain health benefits under the standard eligibility rules of the Public Employees' Medical and Hospital Care Act (PEMHCA). The California State University (CSU) elected to adopt the provisions of this law offering health care coverage (medical, dental and vision) for domestic partners of CSU employees and annuitants subject to the Secretary of State approval process and the CalPERS' acceptance process. Effective 1/1/2020 Assembly Bill (AB) 30 removed the age 62 requirement for opposite-sex domestic partners. For more information, please visit TL-BEN2020-09.
Current Domestic Partner Tax Dependent Certification Form
**The IRS has ruled that the actual cost of the domestic partner benefit is taxable income to the employee. Federal income, social security and Medicare taxes are deducted monthly from the employee’s paycheck upon addition of a domestic partner to the health and/or dental plans.
***Employees who enroll dependents age 24 - 25 may incur additional state income tax liability.
Required Documents
If you plan to enroll any dependents (spouse and/or children), please have the following documents and information available at the Orientation:
- Marriage Certificate (spouse) or
- Declaration of Domestic Partnership (Domestic Partner)
- Birth Certificate (dependent child under 26) or
- Adoption Certificate (adopted child under 26)
- Affidavit of Eligibility for Economically Dependent Children (economic dependent under 26)
- Social Security numbers are required for all dependents
*** All documents must be in English. If they are not, they must be translated and notarized prior to submission.***
Enrollment Deadlines - **Applies to new faculty whose effective appointment date is August 14, 2024 and attends the New Faculty Orientation. **
***New faculty who do not attend the New Faculty Orientation, and whose appointment date is August 21, 2024, the effective date of health and dental coverage will not be effective earlier than October 1, 2024.***
Enrollment forms must be received within 60 days of your appointment. The last day to turn in enrollment forms to the Benefits and Retirement Services team is October 21, 2024. If not submitted with-in the 60 days, there will be a 90 day wait.
Please consult the table below for health plan enrollment deadlines and effective dates.
|
BENEFIT PLAN |
FORMS RECEIVED BY |
EFFECTIVE DATE |
|
HEALTH and/or DENTAL * |
Monday, August 26, 2024 Monday, September 23, 2024 October 21, 2024 |
September 1, 2024 October 1, 2024 November 1, 2024 |
|
FLEXCASH and/or FLEXIBLE SPENDING ACCOUNTS
|
Monday, August 26, 2024 Monday, September 23, 2024 October 21, 2024 |
September 1, 2024 November 1, 2024 November 1, 2024 |
|
VISION (BASIC PLAN) * LIFE INSURANCE * LONG TERM DISABILITY * RETIREMENT
(*) Indicates premium is CSU Paid |
AUTOMATIC ENROLLMENT (no enrollment forms required) |
September 1, 2024
|
If the deadline is missed, employees may enroll in health and dental insurance plans after a 90-day waiting period, from date of receipt of health and dental forms to Human Resources Benefits team, under the Health Care Portability and Accountability Act (HIPPA), or during the annual open enrollment period with coverage effective the following January 1.
Employees are responsible for notifying the Benefit office within 60 days of any life changes that may require changes to their benefit plans, such as marriage, divorce, birth of a child or a child turning age 26.
Health Benefits
Employees that are benefits eligible may enroll in one of several medical plans for themselves and their eligible dependents:
- Monthly plan premium costs shared by the CSU and the employee.
- Employee contribution rates vary depending on the plan selected and the number of dependents enrolled.
- Before enrolling, review the current Health Plan Rates form attached and the information provided below on each plan.
- To find health plans available in your area go to the CalPERS Health Plan Search by Zip Code
- Use the Provider Phone/Website List attached to contact providers for more information.
- Need help choosing a medical plan? Try the CalPERS Health Plan Chooser
What's in a Plan (HMO vs PPO vs EPO vs Combination Plans
- HMO - A Health Maintenance Organization (HMO) plan provides health care from specific doctors and hospitals under contract with the plan. You pay co-payments for some services, but you have no deductible, no claim forms, and a geographically restricted service area.
- PPO - A Preferred Provider Organization (PPO) is similar to a traditional "fee-for-service" plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). You must usually meet an annual deductible before some benefits apply. You're responsible for a certain co-insurance amount and the plan pays the balance up to the allowable amount.
- EPO - The Exclusive Provider Organization (EPO) plan offers the same covered services as an HMO plan, but you must seek services from the plans' PPO network of preferred providers. You're not required to select a primary care physician.
- Combination Plans - A combination plan means at least one family member is enrolled in a Medicare health plan and at least one family member is enrolled in a Basic health plan through the same health carrier. CalPERS requires all family members to have the same health carrier.
Employees select a primary care physician who coordinates all care including referral to specialists.
Anthem BlueCross Traditional HMO California
Anthem BlueCross Select HMO California
- Dedicated to delivering quality care and great value.
- Both plans offer programs that help members become involved in their health and wellness.
- For more information, call (855) 839-4524.
- Access to more than 11,000 personal physicians and 300 hospitals.
- No annual deductible; copayment at each physician visit.
- For more information, call (800) 334-5847.
- Integrated health care system.
- No annual deductible; copayment at each physician visit.
- For more information, call (800) 464-4000.
United Healthcare Alliance HMO California
- Quality patient-centered healthcare at lower costs.
- Distinct network of providers offers collaborative care and health management.
- For more information, call (877) 359-3714.
PERS Platinum (administered by Anthem BlueCross of California)
- Choose your health care providers and pharmacy without referral.
- Offers significant savings through a preferred provider network (doctors and hospitals that agree to charge a pre-negotiated rate for everyone on the plan). Non-network providers may be used, but co-payments will be higher.
- PERS Choice pays 80 percent of allowable amount (in-network), member pays 20 percent; cop-pays are applicable.
- PERS Care pays 90 percent of allowable amount (in-network), member pays 10 percent; co-pays are applicable.
- Annual deductibles must be met before some benefits apply.
- For more information, call (877) 737-7776.
PERS Gold (administered by Anthem BlueCross of California)
- Same level of benefits as PERS Choice at a lower monthly premium cost.
- Available in 54 of the 58 California counties (not available in Alameda, Marin, Placer, or Solano counties, or out-of-state).
- Access a list of preferred providers through the PERS Select network (Approx. 50 percent of the PERS Choice physician network).
- For more information, call (877) 737-7776.
Employees that meet benefits eligibility may enroll in either Delta Dental (PPO) OR Delta Care USA (HMO) for themselves and their eligible dependents. Both plans are administered by Delta Dental of California. The premiums for these dental plans are paid by the CSU.
Delta Dental (Indemnity and PPO)
- Enrollees may select a dentist of their choice.
- Members may choose a dentist in the Delta Premier or Delta Dental PPO network and pay less.
- The plan sets the limits it pays for each specific type of dental treatment. Members are responsible for paying any remaining balance.
- You will need to complete and submit your own claim forms for services provided by a non-Delta dentist.
- Register online for member services and to view your claims.
DeltaCare USA (Dental HMO)
- Enrollees and their eligible dependents are required to use a dentist who is a contracted DeltaCare USA provider.
- Most basic services are covered at no cost.
Dental Plan Enhancements for the PPO
Delta Dental added a couple of new dental enhancements that are effective January 1, 2019 for the Delta Dental PPO Plan: Diagnostic and Preventative Maximum Waiver and SmileWay Wellness Benefit.
When employees visit a PPO dentist, their diagnostic and preventative services (like cleanings and exams) will not count against their annual maximum.
|
Delta Dental Pays |
You Pay |
Your remaining maximum |
|
|
Without D&P Maximum Waiver |
$350.00 |
$100.00 |
$1,650.00 |
|
With D&P Maximum Waiver |
$350.00 |
$100.00 |
$2,000.00 |
SmileWay Wellness Benefit is an enhanced coverage for higher risk employees. Employees with these qualifying diagnosed medical conditions (diabetes, heart disease, HIV/AIDS, rheumatoid arthritis or stroke) are offered expanded coverage such as one periodontal scaling and root planning procedure per quadrant per calendar year covered at 100%. In order to use this great enhancement, employees will need to opt in by going to deltadentalins.com/csu. Log in to their Online Services account. (If they don't have one, click Register.) Click on the Optional Benefits tab in the left column, then click on Opt In next to the name of the person they want to enroll, complete and submit the form. Employees may also sign up by phone at (800) 626-3108 to speak to a Customer Service representative Monday through Friday, 8:00am to 8:00pm, Pacific Standard Time.
All Faculty members appointed for at least 6 weighted teaching units (.40) for one semester or more are automatically enrolled in the vision insurance plan.
- Premiums are paid by the CSU.
- May visit any licensed ophthalmologist, optometrist or dispensing optician of choice.
- Administrator is Vision Service Plan (VSP).
The vision plan includes:
- One comprehensive eye exam every calendar year.
- One pair of lenses every other calendar year (or calendar year if your prescription changes) and one frame every other calendar year.
- Contact lenses every other calendar year when contact lenses are provided in lieu of all other lens and frame benefits.
CSU Vision Plan - Basic
Under VSP, the following vision benefits are available to eligible CSU employees:
- In-network frame allowance - $110
- Out-of-network frame allowance - $60
- In-network contact lens allowance - $120
- Discounts of approximately 15% for laser correction surgery are available
CSU Vision Plan - Premier
All CSU active employees eligible to participate in the CSU VSP Basic Plan are eligible to enroll in the Premier Vision Plan for a small monthly employee cost share. The Premier Vision Plan enables you to get a higher allowance for frames and contacts, fully covered standard progressive lenses, and more discounts.
The CSU will continue to contribute $7.10 towards the monthly premium which appears as a vision deduction on pay warrants. If the employee chooses the Premier Plan, the additional cost will be deducted directly from their pay warrant. Premier Plan will be administered by VSP.
If the employee elects the Premier Plan, any dependents they wish to cover must also be enrolled into the Premier Plan coverage. Employees cannot choose to enroll in both the Basic and Premier vision plan coverage at the same time, or split their enrollment leaving any dependents on the Basic Vision Plan. Eligible employees must enroll through VSP directly.
Under the VSP Premier Plan, the following vision benefits are available to eligible CSU employees:
- In-network frame allowance - $210
- Costco/Sam's Club/Walmart frame allowance - $115
- In-network contact lens allowance - $200
- Polycarbonate lenses are covered for dependent children in-network up to age 23, instead of age 12
- Frames/lenses/contacts every calendar year
Accessing Benefits
- Claim form is not required when using standard in-network benefits.
- Services provided by a non-VSP provider must be paid in full by the employee. For reimbursement, complete a VSP Out-of-Network Reimbursement form
CalPERS Retirement
The California Public Employees Retirement System (CalPERS) offers a defined benefit retirement plan. It provides benefits based on members years of service, age, and final compensation. In addition, benefits are provided for disability death, and payments to survivors or beneficiaries of eligible members. By statute, the California State University (CSU) participates in the CalPERS program. Membership is mandatory for those CSU employees who are eligible.
CalPERS uses contributions of the employer and the employee as well as income from investments to pay for employee retirement benefits. Employee and employer contributions are a percentage of applicable employee compensation and are made on a pre-tax basis; federal and state taxes are deferred until benefits are paid. Any investment return on an employee’s account is also tax-deferred. The investment of contributions are managed by CalPERS; therefore, employees do not bear any investment risk. Employee benefits grow with years of service and final average salary.
For the most current and detailed information, employees can visit the CalPERS website or call CalPERS at (888) 225-7377. Members may log into MyCalPERS to manager their account online.
Employees Eligible for Membership
- Employment at half-time or more for one year or more is covered by CalPERS retirement membership immediately upon appointment of the employee. (Government Code 20305(2))
- Employment with a term of full-time continuous employment in excess of six months is covered by CalPERS retirement membership immediately upon appointment. In addition, shorter duration full-time temporary employment, which is extended to continue beyond six months is covered at the beginning of the first pay period following the completion of 125 days or 1,000 hours of service. (Government Code 20305(3)(A))
- Part-time or intermittent employment exceeding 125 days (if paid on a per diem basis) or 1,000 hours within a fiscal year is covered by CalPERS retirement membership effective the beginning of the first pay period following the completion of 125 days or 1,000 hours of service. (Government Code 20305(3)(B))
- Temporary faculty who work two consecutive semesters or three consecutive quarters at half time or more qualify for CalPERS membership effective with the start of the next consecutive semester or quarter if that appointment requires service of half-time or more. (Government Code 20305(4))
Employees Excluded from CalPERS Membership
- Employment as a student assistant is excluded from CalPERS retirement membership (Note: teaching associates are not excluded from CalPERS membership). (Government Code 20300(c))
- Employment as a youth summer aid under the federal job training partnership act is excluded from CalPERS retirement membership. (Government Code 20300(f))
- Employment in extension programs is excluded from CalPERS retirement membership. (Government Code 20300(j))
- Employment in addition to other full-time employment is excluded from CalPERS retirement membership. (Government Code 20300(k))
- Employment as Senate, Assembly, and Executive Fellow is excluded form CalPERS retirement membership. (Government Code 20300(l))
Pension Reform - Classic vs PEPRA Membership
The California Public Employees’ Pension Reform Act (PEPRA), which took effect in January 2013, changes the way CalPERS retirement and health benefits are applied, and places compensation limits on members.
As defined by PEPRA, a new member includes:
- A member who first established CalPERS membership prior to January 1, 2013, and who is rehired by a different CalPERS employer after a break in service of greater than six months
- A new hire who is brought into CalPERS membership for the first time on or after January 1, 2013, and who has no prior membership in any California public retirement system
- A new hire who is brought into CalPERS membership for the first time on or after January 1, 2013, and who is not eligible for reciprocity with another California public retirement system
All members that don’t fall into the definitions above are considered classic members. Classic members will retain the existing benefit levels for future service with the same employer.
| Type of Employment Covered by CalPERS Membership | Effective Date of Coverage |
|---|---|
| Employment at half-time or more for one year or more. | Immediately upon appointment of the employee. |
| Employment with a term of full-time continuous employment in excess of six months. | Immediately upon appointment of the employee. |
| Shorter duration full-time temporary employment - extended to continue beyond six months. | The first pay period following the completion of 125 days or 1,000 hours of service. |
| Part-time or intermittent employment exceeding 125 days (if paid on a per diem basis) or 1,000 hours within a fiscal year. | The first pay period following the completion of 125 days or 1,000 hours of service. |
|
Temporary faculty who work two consecutive semesters or three consecutive quarters at half time or more (but less than full time). |
The start of the next consecutive semester or quarter if that appointment requires service of half time or more. |
| Temporary faculty appointed full time for an academic year (AY). (HR/Benefits 2003-27) | Immediately upon appointment of the employee. |
As defined by PEPRA, a new member includes:
- A member who first established CalPERS membership prior to January 1, 2013, and who is rehired by a different CalPERS employer after a break in service of greater than six months
- A new hire who is brought into CalPERS membership for the first time on or after January 1, 2013, and who has no prior membership in any California public retirement system
- A new hire who is brought into CalPERS membership for the first time on or after January 1, 2013, and who is not eligible for reciprocity with another California public retirement system
All members that don’t fall into the definitions above are considered classic members. Classic members will retain the existing benefit levels for future service with the same employer.
|
|
PEPRA Membership |
Classic Membership |
|
|
Employment and Membership |
Hired by state and new CalPERS member on or after January 1, 2013. |
Hired by state and new CalPERS member between January 15, 2011 and December 31, 2012 |
Hired by state and new CalPERS member prior to January 15, 2011 |
|
Retirement Formula |
2%@62 |
2%@60 |
2%@55 |
|
Highest Benefit Factor |
2.5%@67+ |
2.418%@63+ |
2.5%@63+ |
|
Vesting |
5 years |
5 years |
5 years |
|
Minimum Retirement Age |
52 |
50 |
50 |
|
Salary used to calculate retirement |
Average highest 36 months (subject to cap) |
Average highest 36 months |
Average highest 12 months |
|
PEPRA Compensation Cap |
2022 $134,974 for Social Security participants $161,969 for Social Security non participants |
N/A |
N/A |
|
401(a)(17) Compensation Limit |
N/A |
2022: $305,000 |
2022: $305,000 Not applicable to employees with CalPERS membership prior to 7/1/1996 |
Note: There are exceptions to CalPERS membership benefit formula eligibility for employees with previous public agency or reciprocal agency employment. See Eligibility for further details.
For further information, visit the CalPERS web site. The following links provide specific information for the topics listed:
- Members are eligible to retire at the age specified in their benefit formulas. CSU members become fully vested in their retirement benefits after five years of credited service.
- Internal Revenue Code (IRC) 401(a)(17) provides dollar limitations on benefits and contributions under qualified retirement plans, including the California Public Employees’ Retirement System (CalPERS). Employees who first became members of CalPERS on or after July 1, 1996, are subject to the 401(a)(17) limit, which restricts the amount of final compensation that can be used to calculate the CalPERS retirement benefit. Employees subject to the limit are exempt from making contributions to CalPERS on earnings that exceed the current year maximum. However, campuses must continue to report the appropriate contribution code, even those above the maximum, so that these employees continue to earn service credit.
|
|
PEPRA Membership |
Classic Membership |
|
|
Employment and Membership |
Hired by state and new CalPERS member on or after January 1, 2013. |
Hired by state and new CalPERS member between July 1, 2011 (January 15, 2011 for Mgmt) and December 31, 2012 |
Hired by state and new CalPERS member prior to July 1, 2011 |
|
Retirement Formula |
2.5%@57 |
2.5%@55 |
3%@50 |
|
Highest Benefit Factor |
2.5%@57+ |
2.5%@55+ |
3%@50+ |
|
Vesting |
5 years |
5 years |
5 years |
|
Minimum Retirement Age |
50 |
50 |
50 |
|
Salary used to calculate retirement |
Average highest 36 months (subject to cap) |
Average highest 36 months |
Average highest 12 months |
|
PEPRA Compensation Cap |
2022: $161,969 |
N/A |
N/A |
|
401(a)(17) Compensation Limit |
N/A |
2022: $305,000 |
2022: $305,000 Not applicable to employees with CalPERS membership prior to 7/1/1996 |
Note: There are exceptions to CalPERS membership benefit formula eligibility for employees with previous public agency or reciprocal agency employment. See Eligibility for further details.
For further information, visit the CalPERS web site. The following links provide specific information for the topics listed:
- Members are eligible to retire at the age specified in their benefit formulas. CSU members become fully vested in their retirement benefits after five years of credited service.
- Internal Revenue Code (IRC) 401(a)(17) provides dollar limitations on benefits and contributions under qualified retirement plans, including the California Public Employees’ Retirement System (CalPERS). Employees who first became members of CalPERS on or after July 1, 1996, are subject to the 401(a)(17) limit, which restricts the amount of final compensation that can be used to calculate the CalPERS retirement benefit. Employees subject to the limit are exempt from making contributions to CalPERS on earnings that exceed the current year maximum. However, campuses must continue to report the appropriate contribution code, even those above the maximum, so that these employees continue to earn service credit.
CalPERS uses contributions of the employer and the employee and income from investments to pay for employee retirement benefits. Employee and the employer contributions are a percentage of applicable employee compensation.
Classic Member Contributions
The employer contribution is set annually by CalPERS based on annual actuarial valuations. The employee contribution is 5% of salary for Miscellaneous Tier 1 members and 8% for Peace Officer/Firefighter members less an exclusion allowance for coordination with Social Security.
|
PEPRA Member Contributions
The employer contribution is set annually by CalPERS based on annual actuarial valuations. The employee contributions can vary by fiscal year for all Plans and are set by CalPERS and subject to provisions of the California Public Employees' Pension Reform Act of 2013.
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| Benefit Plan: PEPRA Miscellaneous Tier 1 - 2% @ Age 62 Formula | |||||||||||||||||||||||
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| Benefit Plan: PEPRA State Safety - 2% @ Age 57 Formula | |||||||||||||||||||||||
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| Benefit Plan: PEPRA Police Officer/Firefighter (PO/FF) - 2.5% @ Age 57 Formula | |||||||||||||||||||||||
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Voluntary Benefits
Contact Information & Additional Resources
** Due to the current situation - the SF State Benefits Team is working remotely with limited staff on campus Monday - Friday 8am - 5pm. In order to continue serving our colleagues with a high level of response we are asking employees to submit a service ticket - HR Client Services Center. You may also use Microsoft Teams to connect with a Benefits Analyst using the below guide based on your last name. **
| Martha Paul | Associate Director, Benefits, Leaves, and Retirement Services | 415.338.1878 | mcpaul@sfsu.edu |
| Lola Thomas (U-Z) | Sr. Benefits' Lead Analyst | 415.338.2683 | ythomas@sfsu.edu |
| Mel Cabrera-Brohmi (K-T) | Benefits Analyst | 415.405.4371 | melca9@sfsu.edu |
| Braulio Alcaraz (A-J) | Benefits Analyst | 415.338.2508 | braulioalcaraz1@sfsu.edu |
| Mary Saw | Retirement Specialist | 415.405.0572 | msaw@sfsu.edu |
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| Benefits Help Line | Main | 415.405.4004 | |
| Service Ticket | HR Client Service Center |