Open Enrollment 2017


2017 Open Enrollment
Monday, September 11, 2017 - Friday, October 6, 2017 at 5:00 pm

The Open Enrollment period allows you to review your current benefits to determine the best options available to you and your family. The annual Open Enrollment period provides benefit eligible employees the opportunity to change their health/dental plans and enroll/re-enroll in the Flexible Spending plans for 2018.

During the open enrollment period, eligible employees may request to:

  • enroll in a health or dental plan, change health or dental plans, or add or delete eligible family members to health or dental plans;
  • enroll or cancel FlexCash – an employee that has an alternate non-CSU medical and/or dental plans may elect to receive FlexCash with appropriate proof of alternate non-CSU coverage.
  • enroll or re-enroll in the flexible spending plans (HCRA or DCRA) for the new 2018 tax year. Current participants who wish to continue the flexible spending plans in the 2018 tax year must re-enroll during the open enrollment period.

 

All Open Enrollment Worksheets, FlexCash forms and Flexible Spending plans (DCRA & HCRA) forms must be submitted no later than 5:00 p.m. on Friday, October 6, 2017.

If you do not wish to make changes, additions or deletions, to your health plans no action is required.

All 2018 health plan rates and Open Enrollment requests will become effective January 1, 2018.   Please check your January 1, 2018 pay warrant to confirm changes.

 

WHAT’S CHANGING FOR 2018
CSU Health Plans: The CalPERS Board of Administration administers the health plans on behalf of the CSU. The 2018 monthly premium has increased for most of the health plans. 

New Vision Service Plan (VSP) Premier: Great news! The CSU is now offering a choice of two vision plans. The VSP Basic Plan is still provided at no cost to you.  During the Open Enrollment period you choose to upgrade to the VSP Premier Plan for a small monthly cost. The VSP Premier Plan allows higher allowances for frames and contacts every calendar year.

If you choose to enroll in the new Premier Vision Plan, please enroll directly with Vision Service Plan (VSP): http://csuactives.vspforme.com or by calling (800) 400-4569.

Healthcare Reimbursement Account: All employees who are currently using the ASIFlex Benny Master Card will be issued the new ASIFlex Visa Debit Card by January 2018. NEW -The Health Care Reimbursement Account (HCRA) contribution has increased to $2,600 for 2018. The monthly maximum is $216.66.

Dental Benefit 2018


How to make health/dental changes or add/delete eligible dependents

Complete the Open Enrollment Benefits Worksheet and CalPERS HBD-12A forms

  • Complete Section 1:
    Employment and personal information.
  1. Use this section to complete your employment and personal information.
  • Complete Section 2:
    Select the Type of Transaction
  1. If you are changing your Medical/Dental plan complete section 2 to indicate your current plan and the new plan you are electing. Your new Medical/Dental will also be selected in Section 3.
  2. If you are adding and/or deleting a dependent(s); circle the ‘Add / Delete’ option in Section 2, then proceed to Section 3 to select your current Medical/Dental plan
  • Complete Section 3:
    Selecting a Medical/Dental Plan
  1. Select the applicable Medical/Dental plan
  • Complete Section 4:
    Enrolling Employee (Self)/Dependent(s) Information
  1. In Section 4 list yourself, current and new dependents, if applicable.   Then circle the “Action” for self and each dependent (e.g. add, delete).
  2. Circle “NA” if you are only changing your MEDICAL OR DENTAL plan but not deleting or adding dependent(s) to your health plan. Sign and date the form.

Please submit the Open Enrollment Benefits Worksheet with the following attachment

  • 2017 Open Enrollment Benefits Worksheet
  • CalPERS HBD-12A form
  • If applicable, required documentation i.e., copy of dependent birth certificate, marriage certificate, Domestic Partnership.  Please note: Social security numbers are required for each dependent.

All Open Enrollment forms/document must be submittedto Human Resources, Joyal Administration, Room 211 no later than 5:00pm on Friday, October 6, 2017. 

  • Due to the State Controller’s deadlines, there are no exceptions.
  • You will receive a receipt from Human Resources after your request is processed.

Please check your January 1, 2017 pay warrant to confirm change(s).

How to Enroll in FlexCash & Cancel Health/Dental

FlexCash Enroll & Cancel Health/Dental:  To enroll in FlexCash complete the Open Enrollment Benefits Worksheet, CalPERS HBD-12A form andthe FlexCash Enrollment Authorization form. 

Enrollment Benefits Worksheet

  • Complete Section 1:
    Employment and personal information
  1. Use this section to complete your employment and personal information.
  • Complete Section 2:
    Select the Type of Transaction
  1. In the “Enroll in FlexCash” box, write the name of the medical/dental plan you are cancelling. Next select the FlexCash option you are enrolling in. Sign and date the bottom of the form.

FlexCash Enrollment Authorization Form

  • Complete Section 1: In Section 1 (Type of Enrollment), select the “Annual/Open Enrollment Newly” box.
  • Complete Sections2-4 with personal information.
  • In Section 5 place the dollar figure in the box “Cash in lieu of…” for the plan you are waiving (medical or dental) and total the monthly amount in box 5C
    • Medical Monthly payment $128.00  
    • Dental Monthly payment   $  12.00  or   - 0 – if no dental FlexCash
    • 5C:  Monthly Total
  • Sign and date the form: Attach proof of alternate non-CSU medical and/or dental plan. 
  • Note: The following individual health insurance policies are not qualifying group health plan coverage for purposes of the FlexCash Benefit Program: Covered California plans, another insurance marketplace plan or coverage under Tricare, Medicare and Medi-Cal.

  • Submit completed Open Enrollment Benefits Worksheet,HBD-12A form and FlexCash Program form to Human Resources, Joyal Administration, Room 211 no later than 5:00pm on Friday, October 6, 2017. 
  • Due to the State Controller’s deadlines, there are no exceptions.  You will receive a receipt from Human Resources after your request is processed

Please check your January 1, 2018 pay warrant to confirm change(s). 

How to Cancel FlexCash & Enroll in Health/Dental

 

FlexCash Cancel & Enroll in Health/Dental:  To cancel your current FlexCash enrollment and enroll in a health and/or dental plan, please complete the Open Enrollment Benefits Worksheet, CalPERS HBD-12A form andthe FlexCash Enrollment Authorization form. 

 

 

 

Enrollment Benefits Worksheet

 

  • Complete Section 1:
    Employment and personal information

 

  1. Use this section to complete your employment and personal information.

 

  • Complete Section 2:
    Select the Type of Transaction

 

  1. Select the “Cancel FlexCash” box and then check the applicable box for Enroll in “Medical Plan” and/or “Dental Plan”.

 

  • Complete Section 3:
    Selecting a Medical/Dental Plan

 

  1. Select the applicable Medical/Dental plan.

 

  • Complete Section 4:
    Enrolling Employee (Self) / Dependent(s) Information

 

  1. In Section 4 list yourself, and dependents, if applicable.   Then circle the “Action” for self and each dependent (e.g. add).  
  2. Circle “NA” if you are only changing your MEDICAL OR DENTAL plan but not deleting or adding dependent(s) to your health plan.   Sign and date the form.

 

FlexCash Enrollment Authorization

 

  • Complete Section 1: In Section 1 (Type of Enrollment) select the “Cancellation” box.
  • Complete Sections2-4 with personal information.
  • In Section 5 place a “- 0-“ in the box “Cash in lieu of…” for the plan (medical or dental) you are cancelling.  
  • NOTE: If you are cancelling only one of two FlexCash plans, please note the “-0-“ in the cancelled plan and a dollar amount in the continued FlexCash plan.
  • Sign and date the form.
  • Submit completed Open Enrollment Benefits Worksheet,HBD-12A form and FlexCash Program Enrollment Authorization with required documentation (copy of alternate non-CSU plan and if covered by spouse’s alternate plan copy of marriagecertificate/Domestic Partnership).

 

    • EXAMPLE
       
      Medical Monthly payment $128.00  
    • Dental Monthly payment   $  - 0 –   (canceling dental FlexCash)
    • In 5C please total the monthly amount.

 

  • Open Enrollment documents must be submitted to Human Resources, Joyal Administration, Room 211 no later than 5:00pm on Friday, October 6, 2017.  Due to the State Controller’s deadlines, there are no exceptions.

  • You will receive a receipt from Human Resources after your request is processed.

 

 

 

Please check your January 1, 2018 pay warrant to confirm change(s).

 

HCRA/DCRA Enrollment & Re-enrollment Process

If you are currently participating in one of these flexible spending plans and wish to continue your deduction for the next tax year or would like to start participating:

Complete the Dependent Care/Health Care Reimbursement Account Plans Enrollment Authorization form. 

    • Complete Sections 1-4:
      Type of Enrollment and personal information
      • Use this section to select your enrollment reason – “OPEN Enrollment”
      • Complete the personal information portion in sections 2-4
    • Complete Section 5:
      Benefit Deduction Item
      • INITIAL next to the applicable account you are enrolling in, i.e., DEPENDENT CARE or HEALTH CARE.
    • Complete Section 7-8:
      Monthly Deduction Amount
      • Enter the applicable monthly deduction amount in Section 7.
      • Maximum pre-tax deduction amounts for 2018:
        - HCRA amount is $216.66 monthly ($2,600 annual maximum)
        - DCRA amount is $416.66 monthly ($5,000 annual maximum)
      • Read Section 8 and then sign/date. 
  • Submit completed Dependent Care/Health Care Reimbursement Account Plans Enrollment Authorization form to Human Resources, Joyal Administration, Room 211 no later than 5:00pm on Friday, October 6, 2017. 
  • Due to the State Controller’s and ASIFlex deadlines, there are no exceptions.
  • You will receive a receipt from Human Resources after your request is processed.

Please check your January 1, 2018 pay warrant to confirm change(s).

ASIFlex VISA Debit Card (HCRA only): This card provides you the option to have HCRA-related expenses automatically deducted from your HCRA account.   To request the ASIFlex Debit Card, complete the “ASIFlex Debit Card Application” form and submit the form to ASIFlex.   Two (2) cards will be issued.   The fee of $12.00 for this card is deducted directly from your HCRA account by ASI Flex as a non-refundable, one-time, lump sum amount.

Workshops & Events

Benefits & Open Enrollment Workshops - Register for Course Code #000647

Learn more about the health plans, new 2018 premium rates, dental and vision plans, CSU tax shelter annuity plan, voluntary plans and flexible spending plans.  The benefits team will be available to assist you with Open Enrollment questions.

Wednesday, September 20, 2017
University Business Center
Peters Building Room 192

9:00 am – 10:00 am
Course Session #0006

Tuesday, October 3, 2017
University Business Center
Peters Building Room 192
11:00 am – 12 Noon
Course Session #0007

Benefits Fair & Wellness Expo

This annual event allows employees to visit with over 50+ benefits and community wellness partners in preparation for the annual open enrollment period.  No registration needed.

Thursday, September 28, 2017
Satellite Student Union
Time:  10:00 AM – 1:00 PM
 

CSU Voluntary Benefit Plans

CSU Voluntary Benefit Plans

The Open Enrollment period also provides you with the opportunity to enroll or disenroll in the following voluntary plans.

 

  • The Standard Insurance Enhancement 
  • Aflac Critical Care Illness Insurance 
  • MetLaw, Legal Services 
  • California Casualty Insurance

    Voluntary Benefits

For additional information, please review the CSU Open Enrollment website http://csyou.calstate.edu/openenrollment