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Get the latest information about Fall 2021 Repopulation and COVID-19. Before coming to campus, take the COVID-19 Daily Screening.


Benefits Information by Category

Submitting Benefits and Fee Waiver Forms with Supporting Documents
All documents must be submitted using the MOVEit, a secure document transfer software.    The step-by-step instructions for submitting documents to the Benefits team is provided here.

Benefits Documents:
  • Benefits Worksheet
    • Family Status Changes Benefits Worksheet with documents (add/delete dependent(s), marriage, domestic partnership , divorce, death, gain or loss of non-CSU health coverage)
    • New hire Benefits Worksheet with documents (birth certificate, marriage certificate, domestic partnership) 
  • Dependent Eligibility Verification Affidavit and supporting documents
  • CalPERS Parent-Child Relationship Affidavit and supporting document(s)
  • CalPERS Service Purchase Requests
  • Fee Waiver - Employee and Dependent forms with class schedule
  • FlexCash forms and supporting documents (eligible requests due to gain or loss of coverage or new hire)
  • Health Care Reimbursement Account (HCRA) and Dependent Care Reimbursement Account (DCRA) [eligible requests to stop/start/change deduction].  Please review HCRA and/or DCRA Brochure.

COVID-19 LEAVE Requests:

  • If you have been exposed to someone who has tested positive or is strongly suspected to have COVID-19, or have symptoms - Complete the online form. Once the initial report is received by Environmental Health and Safety (EH&S), someone will contact you regarding quarantine/isolation period.  Please notify your supervising manager. Human Resources will be notified by EH&S.
  • Request due to school/daycare closure
    * Staff & MPPs -
    * Faculty (Unit 3) & Unit 11 –