Plan Enrollments

Benefit Plan Enrollment

The deadline for enrollment in benefits is 60 calendar days from the date of hire of eligibility. If the deadline is missed, employees may enroll in health insurance after a 90-day waiting period under the Health Care Portability and Accountability Act (HIPPA), or during the annual open enrollment period with coverage effective the following January 1. Changes to plans may be made during the open enrollment period.

Eligible employees may enroll for self only or for self and all eligible family members (who are not otherwise enrolled as an employee, annuitant or dependent under the PEMHCA Health Benefits Program).

Family members are defined as

Spouse (married couples are required to provide a copy of their marriage certificate and their spouse’s Social Security number)
Domestic Partner (copy of a of Declaration of Domestic Partnership is required)
Children (under age 23 and never married) natural, adopted children, or stepchildren of the member; children of domestic partners (an Affidavit of Eligibility HBD-35 form is required) that meets above criteria
Another person’s child under the age of 23, who has never married, may be eligible for coverage if:
- The employee has been granted legal custody or joint legal custody of the child; or
- The child resides with the employee or annuitant (generally in the absence of the natural or adoptive parent), and is economically dependent upon the employee or annuitant; or
- The child is the natural, adopted, step or economically dependent child of the employee or annuitant’s domestic partner.
A child over age 23, who has never married and who is incapable of self-support because of a mental or physical disability that existed prior to age 23, may be included on an employee’s initial enrollment or continued enrollment. Request to continue enrollment must be received 60 days prior or 60 days after the child’s birthday. The employee or annuitant must submit the following:
- Member Questionnaire for the CalPERS Disabled Dependent Benefit (HBD-98); and
- Medical Report for the CalPERS Disabled Dependent Benefit (HBD-34)

Note: The enrollment of a disabled child over age 23 is subject to CalPERS approval.

Health Plan Enrollment

The Benefits Worksheet must be completed along with appropriate documents/information required and returned (hand delivered is preferred) to the Human Resources Office, Joyal Administration Building, Room 164 on or before the 60-day time limit without a 90-day waiting period. Generally, the effective date of enrollment is the first of the following month that the Health Plan Enrollment Form is received in the Human Resources Office.

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. It is essential to evaluate each plan against your personal and family needs prior to making a selection.

Dental Plan Enrollment

The Benefits Worksheet must be completed along with appropriate documents/information required and returned (hand delivered is preferred) to the Human Resources Office, Joyal Administration Building, Room 164 on or before the 60-day time limit without a 90-day waiting period. Generally, the effective date of enrollment is the first of the following month that the Dental Plan Enrollment Form is received in the Human Resources Office.

The premiums for the dental plans are paid entirely by the CSU, but both plans vary in benefits and co-payments depending on eligible level. It is important to evaluate each plan based on personal and family needs.

The two dental plans available are:

A Managed Care Plan (HMO): DeltaCare USA. This plan has two levels. The eligible level is determined by the employee’s bargaining unit. Employees must select a dentist from with DeltaCare 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.
An indemnity plan (PPO): Delta Dental. This plan has three levels. The eligible level is determined by the employee’s bargaining unit. This is a fee-for-service plan allows employees to select their own dentist. This plan has a deductible.

Vision Plan Enrollment

Eligible employees will automatically be enrolled in the vision plan. The CSU covers the premium for the employee and any dependents. The provider is Vision Service Plan (VSP). Generally, the effective date of enrollment is the first of the following month of the employees eligible hire date.

The vision plan benefit allows one comprehensive calendar year examination and one set of lenses and one frame, or contact lenses, every calendar year. There is a $10 co-payment for this benefit.

FlexCash Plan Enrollment

Employees who have a non-CSU health and/or a non-CSU/state sponsored dental coverage can elect to participate in the FlexCash plan to obtain cash in lieu of CSU coverage. The Benefits Worksheet must be completed along with appropriate documents/information required and returned (hand delivered is preferred) to the Human Resources Office, Joyal Administration Building, Room 164 on or before the 60-day time limit without a 90-day waiting period. Proof of alternate non-CSU insurance coverage is required. This money is taxable income.

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

What you should consider before enrolling into the FlexCash Program:

Medical and dental needs are adequately met through other non-CSU insurance Coverage
Cash payment stipends are considered taxable income
Enrollment in the program waives medical and/or dental continuation rights to a surviving spouse in the event of an employee’s death
Enrollment in the program waives the Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation rights in the event the employee is terminated or otherwise loses eligibility for benefits
Employees retiring while enrolled in the FlexCash Program will have 30 days following retirement to enroll in any PERS medical and or CSU dental plan. Please contact Human Resources regarding enrollment prior to retirement
Employees who lose their other non-CSU coverage while on the FlexCash Plan will have the opportunity to enroll in a medical and/or dental plan with proof of loss of coverage within 60 days of loss of coverage

The FlexCash Enrollment Form must be completed and returned (hand delivered is preferred) to Human Resources Office, Joyal Administration Building, Room 164 on or before the 60-day time limit without a 90-day waiting period. The effective date of enrollment will be given at the time the FlexCash Enrollment Form is received in the Human Resources Office.

Tax Advantage Premium Plan (TAPP) Enrollment

Employees electing health coverage through the CSU are automatically enrolled 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. To decline enrollment in the Tax Advantage Premium Plan (TAPP) the Non-Participating Tax Advantage Premium Plan (TAPP) Form must be completed and returned to the Human Resources Office, Joyal Administration Building, Room 164.

Basic Life/AD&D Insurance & Long Term Disability (LTD) Enrollment

Eligible employees will automatically be enrolled these plans based on their bargaining unit. The CSU covers the premium for these plans. Generally, the effective date of enrollment is the first of the following month of the employee’s eligible hire date.

For information pertaining to eligibility & coverage amounts:

Flexible Spending Plan Enrollment

Health Care Reimbursement Account (HCRA)

The Health Care Reimbursement Account Enrollment Form must be completed and returned (hand delivered is preferred) to the Human Resources Office, Joyal Administration Building, Room 164 on or before the 60-day time limit. The effective date of enrollment will be given at the time the Health Care Reimbursement Account Enrollment Form is received in the Human Resources Office.

This flexible spending account allows employees to pay for eligible health and dental expenses not covered by their insurance with pretax dollars for themselves and their dependents.

All benefit eligible employees are able to participate. There is a 60-day time limit for new hire employees; if this period is missed, the employee must enroll during the annual Open Enrollment period. Participants must re-enroll each year during the Open Enrollment period for the following calendar year.

The minimum monthly deduction is $20.00, and the maximum is $416.66, for a total of $5,000 per calendar year. A claim form must be submitted, with supporting documentation, to ASI, the third party administrator, for reimbursement. Deduction calculations must be done carefully, as money which is not spent by the end of the calendar year is not rolled into the next year. There is a $1.00 monthly after-tax administrative fee charged for each account.

Dependent Care Reimbursement Account (DCRA)

The Dependent Care Reimbursement Account Enrollment Form must be completed and returned (hand delivered is preferred) to the Human Resources Office, Joyal Administration Building, Room 164 on or before the 60-day time limit. The effective date of enrollment will be given at the time the Health Care Reimbursement Account Enrollment Form is received in the Human Resources Office.

This flexible spending account allows employees to pay for day care expenses for children under 13, or an incapacitated spouse or other dependent adult who lives with the employee.

All benefit eligible employees are able to participate. There is a 60-day enrollment window for new hire employees; if this is missed, the employee must enroll during the annual Open Enrollment period. Participants must re-enroll each year during the Open Enrollment period for the following calendar year.

The minimum monthly deduction is $20.00, and the maximum is $416.66, for a total of $5,000 per calendar year. A claim form must be submitted, with supporting documentation, to ASI, the third party administrator, for reimbursement. Deduction calculations must be done carefully, as money which is not spend by the end of the calendar year is not rolled into the next year. There is a $1.00 monthly after-tax administrative fee charged for each account.

Pre-Tax Parking Deduction Plan Enrollment

Payment for Fresno State parking is deducted from the employee’s pay warrant prior to federal, state, Social Security, and Medicare taxes being calculated. Employees are automatically enrolled in the Pre-Tax Parking Deduction Plan, unless they choose not to do so. To cancel the Pre-Tax parking deduction from your pay warrant the Pre-Tax Parking Cancellation form must be completed and returned (hand delivered is preferred) to Human Resources Office, Joyal Administration Building, Room 164. Employees that are not eligible for parking through payroll deduction are not eligible to participate in the Pre-Tax Parking Deduction Plan.

Qualifying Event Changes Outside of Open Enrollment

Mandatory Changes

Newborn or adopted child of the employee - The coverage starts at birth, or when the employee receives physical custody of the adopted child. While this coverage is mandatory, it is not automatic and a Health Plan Enrollment Form (HBD-12) must be completed and returned (hand delivered is preferred) to the Human Resources Office, Joyal Administration Building, Room 164.

Mandatory Family Member Deletions

Death of a dependent
Marriage of an enrolled child, prior to age 23
Enrolled child attains age 23
Family member enrolled as an employee, or as a dependent of another PEMHCA enrollee
Divorce of spouse

The effective date of all mandatory transactions is the first of the month following the event.

The Health Plan Enrollment Form (HBD-12) must be completed to delete a family member and returned (hand delivered is preferred) to the Human Resources Office, Joyal Administration Building, Room 164.

Permissive Family Member Additions

Marriage – Enrollment of a new spouse and/or stepchild, within 60 days following marriage. The coverage will become effective the first of the following month that the Health Plan Enrollment Form (HBD-12) is completed and returned (hand delivered is preferred) to the Human Resources Office, Joyal Administration Building, Room 164. It is required when enrolling a spouse that the employee provides a copy of the marriage certificate and their spouse’s social security number.
Economically/Dependent child – An employee can enroll an economically dependent child who resides with the employee, within 60 days following the date the child became a family member. The coverage will become effective the first of the following month that the Health Plan Enrollment Form (HBD-12) is completed and returned (hand delivered is preferred) to the Human Resources Office, Joyal Administration Building, Room 164

Permissive Family Member Deletions

Deletion of ALL family members, without explaining the reason
Deletion of spouse who moves out of the household (upon cancellation, can only re-enroll by HIPAA or Open Enrollment)
Child has attained age 18
Family member enters military service
Family member obtains other group coverage
Custody changes for child under age 18

The effective date of all permissive transactions is the first of the month following the date the enrollment form is received in the employing office.

NOTE: The coverage of family members who are not enrolled during the initial 60 day time limit may be established during the annual open enrollment period, or through HIPPA.