Benefits
Medical Benefits
Selecting the medical benefits that best meet you and your family’s needs can be challenging. There are a number of resources available to assist you in your selection process.
CalPERS offers a Health Planner Chooser that allows you to:
- Rank health plans for cost
- Find out about doctor availability and hospital affiliation
- Read about member satisfaction
- Learn more about covered services
Note: The 2010 employer premium contribution amount for Employee Only is $493, Employee + 1 is $936 and Employee + 2 or more is $1,202.
A Health Benefits Comparison 
is also available to help you understand the basic differences between a Preferred Provider Organization (PPO) and a Health Maintenance Organization (HMO).
The 2010 CalPERS Basic Rate Comparison 
outlines the employee’s monthly premiums for each health plan.
The CalPERS 2010 Health Program Guide and 2010 Health Benefit Summary booklets provide comprehensive information on the health care plans available to you.
CalPERS has created a new publication titled 2010 Your Health Care, Your Choices that provides valuable tips on choosing a health plan, doctor, hospital, and medical group. See how satisfied members are with their health plan and learn about the tools and resources CalPERS offers to help you choose a plan and providers.
Listed below are the Web sites for the CSU’s medical benefit providers. Details on physicians, hospitals, wellness programs and other valuable information are available to help employees make a decision regarding which health plan to choose.
Health Benefit Providers Contact and Evidence of Coverage Information
Health Maintenance Organizations (HMO)
Blue Shield of California and Kaiser administer our HMO plans.
Web site: Blue Shield Access+ (Group #PH001) and Blue Shield NetValue (Group # PH0010)
Phone: 800-334-5847
Evidence of Coverage Booklets:
Web site: Kaiser (Group #105701)
Phone: 800-464-4000
Evidence of Coverage Booklet:
Preferred Provide Organizations (PPO)
Anthem Blue Cross administers the PPO plans.
Web site: PERS Care(Group #KB010A), PERS Choice (Group #CB010A) and PERS Select (Group #SB010A)
Phone: 877-737-7776
Evidence of Coverage Booklets:
Enrollment
Newly eligible employees have 60 days from the date of hire or eligibility to enroll. If the enrollment form is submitted prior to the end of the month, and within the 60-day timeframe, coverage will become effective the first day of the following month. Employees who fail to enroll within the sixty (60) day timeframe will delay the effective date of medical coverage for a minimum of ninety (90) days after submitting the appropriate document to the Benefits office.
Due to the length of time required to process information through the State Controller’s Office, your eligibility status may not be registered with the health care providers for several weeks. Should you need to schedule an urgent medical appointment, our Benefits representatives can assist you. Please call 619-594-1144 for assistance.
If you wish to change medical plans, you may do so during the annual open enrollment period held during the Fall.
Split Enrollments
Married employees or retirees can enroll separately. However, when married employees are enrolled in a CalPERS health plan in their own right, one parent must carry all children on one plan. Children and dependents cannot be split between parents. When split enrollments are discovered, they will be retroactively canceled by CalPERS. You may be responsible for all costs incurred from the date the split enrollment began.
Dual Coverage
Dual coverage occurs when employees are enrolled in a CalPERS health plan as both a member and a dependent, or as a dependent on two enrollments. When dual coverage is discovered, the enrollment that caused the dual coverage will be retroactively canceled by CalPERS. Employees may have to pay for all costs incurred from the date the dual coverage began. Dual coverage from a non-CalPERS agency is permissible.
Family Status Changes — Adding or Deleting Dependents
If you wish to add/delete dependents due to a family status change, please complete the Benefits Enrollment/Change Form. This form will need to be submitted to Human Resources within 60 days of the family status change. Additional documentation will be required (i.e., Marriage Certificate, Declaration of Domestic Partnership, Affidavit of Eligibility, Final Divorce Decree, or Termination of Domestic Partnership).
Family Status Changes include:
- Marriage (Marriage Certificate), Domestic Partnership (Declaration of Domestic Partnership)
- Birth of a child, adoption, acquisition of a dependent child (economically dependent child)
- Marriage of an eligible Dependent Child (natural, adopted or economically dependent)
- An eligible dependent’s change in residence resulting in cessation of coverage under any health maintenance organization offered through the plan
- Divorce, Legal Separation, Termination of Domestic Partnership, and Death