Benefits Open Enrollment
This year's annual Open enrollment period begins September 15, 2014 and ends October 10, 2014. Open enrollment is your once-a-year opportunity to learn about new offerings and to make additions, changes or deletions to your benefits, which will be effective January 1, 2015.
Employees have the opportunity to:
Enroll in health/dental/vision/flexcash (if benefits eligible)
Change insurance plans
Add/delete eligible dependents
Enroll/Re-enroll in Flexible Spending Accounts - Health Care Reimbursement Account (HCRA) and/or Dependent Care Reimbursement Account (DCRA)
Enroll in/Cancel MetLaw enrollment
Please be advised that CalPERS is responsible for the distribution of health plan (e.g., medical) information to CSU employees during open enrollment. CalPERS will mail health plan open enrollment packets to enrolled employees between August 19, 2014 and August 26, 2014. Employees enrolled after July 1, 2014 will not receive packets, the information can be viewed electronically online by visiting the CalPers Website.
2014 Employee Services Fair
September 25, 2014 10:00 am – 2:00 pm at the Student Union Ballroom
Human Resources will be hosting our annual Employee Services Fair on Thursday, September 25th from 10:00am to 2:00pm in the Student Union, Ballroom. The fair will offer employees the opportunity to learn more about health plans that will be effective January 1, 2015 as well as local programs that can improve employee health and wellness. Nearly 70 vendors are expected to attend, including a wide range of health care groups, investment groups, and wellness companies. Fair attendees will be eligible to win raffle prizes from participating vendors.
Benefits Staff will be on hand at the fair to assist any employees with their on-line open enrollments/changes.
Benefit elections and changes during Open Enrollment must be made online through MySJSU Self-Service and will take effect on January 1, 2015. You can access it from any computer with Internet access by logging on to your MySJSU and selecting Main Menu > Self Service > Benefits > Open Enrollment.
You will need your SJSUOne username and password to log in. Also, please submit an e-Benefits Self Service Electronic Signature Authorization Form, if you haven't done so already.
The deadline for submission of Open Enrollment elections is October 10, 2014.
Elections or cancellations of voluntary benefits, must be handled directly with the plan (see Voluntary Plans section below).
Any employee who makes changes must have all supporting documents on file. Last year during the CalPERS DEV (Dependent Eligibility Verification) audit some employees submitted birth and marriage certificates to HMS, however these documents were not forwarded to the San Jose State Human Resources Office. We may need copies from you.
2015 Health Costs and Changes
Health premiums for 2015 will increase by an average of 3%, the lowest since 1998. This includes basic coverage increases of 3.8% for HMO’s, and 0.6%, for PPO’s. To learn more about the new 2015 Health Plan Rates and plan information, please refer to the information below:
Highlighted below are 2015 health plan changes:
- Blue Shield will no longer require the use of Centers of Excellence for knee/hip replacements.
- Blue Shield has eliminated the $250 outpatient hospital copay for upper endoscopies, colonoscopies, cataract surgery, and knee injections.
- Employees currently enrolled in Blue Shield’s NetValue plan residing in Humboldt County will need to choose a different health plan for 2015. Employees who fail to choose a new health plan during open enrollment, will automatically be enrolled in PERSChoice by CalPERS.
- Inclusion of Acupuncture and Chiropractic benefits for all HMO plans.
Plans that don't currently offer Acupuncture or Chiropractic services will provide twenty (20) annual visits (combined) for these services, regardless of medical necessity, at the standard office visit copay level ($15).
- Adoption of High Performance Generic Step Therapy (HPGST) for HMO, EPO and PPO plans.
High Performance Generic Step Therapy encourages the use of a preferred drug prior to the utilization of a non-preferred drug. The preferred drug is FDA recommended and represents the most cost-effective drug for a given condition. Per CalPERS, an established evidence-based protocol must be met before a non-preferred specialty drug will be covered. It is important to note that the targeted brands in HPGST have generic alternatives within therapeutic classes and the dispensing of a generic alternative requires a new prescription from the prescriber.
- Implementation of Affordable Care Act (ACA) maximum out-of-pocket (MOOP) requirements. For 2015, the ACA limits maximum out-of-pocket (MOOP) amounts for health plans to $6,600/$13,200 for individuals/families, for both medical and pharmacy benefits combined.
- The HMO/EPO plans presently have a $1,500/$3,000 MOOP for medical benefits, and no MOOP for pharmacy benefits. The inclusion of a $5,100/$10,200 MOOP for pharmacy benefits will allow the plans to meet the law's requirement with no impact on premiums.
- The PPO plans presently have no MOOP for medical or pharmacy benefits. The inclusion of a $4,600/$9,200 MOOP for medical benefits and $2,000/$4,000 for pharmacy benefits will allow the plans to meet the law's requirement with no impact on premiums.
You should refer to each health plan's Evidence of Coverage (EOC) booklet for a complete explanation of the benefits covered, as well as limitations. CalPers Website
CalPERS Online Tools
CalPERS has two helpful online tools that employees can utilize to review important
health plan options and information during open enrollment, which include the Health
Plan Search by zip code tool and the Health Plan Chooser tool. The Health Plan Search by Zip Code Tool is an online tool that identifies which plans are available within a particular zip
code. To use the online tool, simply enter your residential or work zip code, then
Search to view the results.
The online Health Plan Chooser tool helps employees compare the features and estimates out-of-pocket cost for each plan, search for doctors, and compare and rank plans based on personal preferences. Complete the Health Plan Chooser’s five steps, and the tool provides a Results Summary chart highlighting the plan(s) rated as the best fit in each category.
Premiums for dental plans will continue to be fully paid by the CSU , with no cost to the employee. All coverage levels and plan benefits will remain the same for the 2015 plan year.
San Jose State continues to offer both an HMO and PPO dental plan. Please refer to the Evidence of Coverage (EOC) booklets for a complete explanation of the benefits covered within
each dental plan, as well as limitations and exclusions that apply. These documents, along with additional information on the dental plans, can be reviewed online through the Delta Dental Website.
Health Care Reimbursement Account (HCRA) and Dependent Care Reimbursement Account (DCRA)
HCRA is a voluntary benefit plan offering eligible employees the ability to pay for qualifying out-of-pocket health care expenses with pre-tax dollars. Employees may elect a monthly deduction amount of as little as $20 per month up to a maximum $208.33 per month. For more information, please review the brochure for HCRA.
DCRA is a voluntary benefit plan offering eligible employees the ability to pay for
qualifying out-of-pocket dependent care expense with pre-tax dollars. Employees may
elect a monthly deduction amount of as little as $20 per month up to a maximum of
$416.66 per month. For more information, please review the brochure for DCRA.
Please remember that Health Care Reimbursement Accounts (HCRA) and Dependent Care Reimbursement Accounts (DCRA) do not automatically continue into the next plan year. If you want deductions to continue for 2015, you must submit your elections via MySJSU self service during the Open Enrollment period, which runs from September 15 thru October 10, 2014. To enroll in the Flexible Spending Account Benny Card, complete the Debit Card Request Form.
Voluntary Benefit Plans
Additional information regarding these voluntary benefit plans and how to enroll can be found on the CSU Systemwide Benefits Portal. Please note that all of the voluntary benefit plans below, with the exception of the MetLaw Legal plan, allow employees to enroll throughout the year.
This is your annual opportunity to enroll or discontinue enrollment in the MetLaw Legal plan for a low monthly premium of $19.70. The MetLaw Legal plan offered by Hyatt Legal Plans, Inc., provides representation for many personal legal services for employees and their eligible dependents. Current employees that do not enroll in the plan during open enrollment will not have another opportunity to enroll in the plan until next year's open enrollment period. Please visit the MetLaw website for plan details.
AFLAC offers critical illness insurance which provides payments for certain wellness exams, and a cash benefit if you're diagnosed or treated for a covered critical illness. Please visit AFLAC's website for plan details at AFLAC.
Voluntary Life Insurance
Although Standard does not offer a formal open enrollment period for Voluntary Life Insurance, employees can enroll in the benefit at any time during employment. If an employee chooses to enroll after the first 60 days of hire or eligibility, the employee must submit a completed medical questionnaire along with the enrollment form. Please visit The Standard website for plan details.
Voluntary Long Term Disability Insurance
The Voluntary Long Term Disability Plan administered by The Standard provides loss of income protection (up to 60%) due to a qualified disability. The vendor offers two (2) different plan options which include a 30 or 90 day waiting period. Eligible employees can enroll in the benefit at any time during employment. If an employee chooses to enroll after the first sixty (60) days of hire or eligibility, the employee will be subject to Evidence of Insurability (EOI) requirements. Please visit The Standard website for plan details.
The Auto and Home Insurance plan offered by California Casualty allows CSU eligible employees to obtain auto and home insurance policies at a discounted rate. The plan also has an identity theft component known as ID Defense. All policies are written for a 12-month period. Eligible employees can enroll in this benefit at any time during employment. Please visit the California Casualty website for plan details.
Retiree Health Plan Changes
If you are a retiree, you should have received information from CalPERS in the mail about open enrollment from September 15 – October 10, 2014. Please call CalPERS at (888) CalPERS (225-7377) for assistance in making your open enrollment changes, or you can visit your MyCalPERS for a Guide to Changing Your Health Coverage.