Benefits Open Enrollment

This year's annual Open Enrollment period begins September 16, 2015 at 2:00 p.m. and ends October 9, 2015. 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, 2016.

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 17, 2015 through August 24, 2015. Employees enrolled after July 1, 2015 will not receive packets, the information can be viewed electronically online by visiting the CalPERS Website, or you may contact Human Resources at (408) 924-2250.


2015 Employee Services Fair

September 29, 2015 10:00 a.m. – 2:00 p.m. at the Student Union Ballroom

Human Resources will be hosting our annual Employee Services Fair on Tuesday, September 29 from 10:00 a.m. to 2:00 p.m. in the Student Union, Ballroom. The fair will offer employees the opportunity to learn more about health plans that will be effective January 1, 2016 as well as local programs that can improve employee health and wellness. Over 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 door prizes from participating vendors.

Benefits Staff will be on hand at the fair to assist any employees with their on-line open enrollments/changes.

Enrollment Procedures

Benefit elections and changes during Open Enrollment must be made online through MySJSU Self-Service and will take effect on January 1, 2016. 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 9, 2015.

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.

2016 Health Costs and Changes

To learn more about the new 2016 Health Plan Rates, plan information and changes, please refer to the information below:

2016 CalPERS Health Benefits Program

Benefits Make a Difference

Highlighted below are 2016 health plan changes:

  1. Anthem Blue Cross and Blue Shield of California are introducing Welvie, an online tool that will help educate members and place more power in their hands when it comes to minimizing unnecessary and inappropriate surgeries. 
  2. Inclusion of Acupuncture and Chiropractic benefits for the PERS/Care, Choice, and Select Plans and all three Medicare Supplemental plans Choice/Care/Select plans. a. 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). 
  3. Blue Shield of California will be enhancing the Prescription (Rx) benefit with a 90-day supply options allowing members the option to fill their prescriptions at select retail pharmacies. 
  4. United Healthcare has expanded its service area to also encompass Kings, Marin and San Diego Counties.
      1. United Healthcare Rx to offer a 90-day supply option at select participating retail pharmacies at the mail order price. 
  5. Health Net SmartCare is expanding into Alameda, Contra Costa, Fresno, Kern, Kings, Napa, Sacramento, San Francisco, San Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, Sonoma, Tulare and Yolo Counties.
  6. United Healthcare will be the single carrier for Medicare. This change will not affect the PERS Care/Choice/Select, or Kaiser Permanente Medicare plans. This plan will allow all plan members to receive care from any willing Medicare provider in California and across the country. It covers all of the care covered by Medicare Parts A, B and D and includes a comprehensive national network of contracted health care providers. United Healthcare Medicare Advantage (MA) Preferred Provider Organization (PPO) will be offered in all 58 counties in California and out of state. 
    1. United Healthcare Medicare will also offer House Calls and Silver Sneakers programs to members.
      1. The HouseCalls program is an innovative home assessment program available nationally to qualified members of select United Healthcare Medicare Advantage plans at no cost to members. Helps to prevent complications by identifying gaps in care; increases adherence to care plan and care coordination and collaboration with member’s primary care physician.
      2. Silver Sneaker fitness program helps members with staying physically fit and active at no additional cost. The program allows members to choose a fitness center from more than 11,000 participating locations which offer classes, cardio equipment, resistance machines, free weights and heated pools (at certain locations). Many locations offer women-only fitness such as Curves nationwide.

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.

Dental Plans

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 2016 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.

Vision Services Plan (VSP)

CSU is pleased to continue providing CSU employees with a comprehensive vision plan for the 2016 plan year. The rates for the employer sponsored vision plan administered by Vision Service Provider (VSP) will remain the same for the 2016 plan year. The Plan will change to the Advantage Network from the VSP Regional Network Plan. 

The VSP’s Advantage Program will bring employees much more value due to many additional discounts and access to promotional programs within VSP; such as many popular lens enhancements (progressive, anti-reflective, photochromic, scratch resistant coating, polycarbonate, plastic dyes and UV protection). CSU employees will also receive a 20% savings on amounts over allowances. See the VSP Benefits Summary. The monthly vision premiums will continue to be fully paid by CSU for the 2016 plan year.

Health Care Reimbursement Account (HCRA) & Dependent Care Reimbursement Account (DCRA)

Employees who wish to continue to participate in the Dependent Care Reimbursement Account (DCRA) and/or Health Care Reimbursement Account (HCRA) plan(s) must re-enroll annually during open enrollment. Administrative and Debit Card fees remain the same in 2016. 

The Health Care Reimbursement Account (HCRA) has increased its annual maximum. The 2016 annual maximum is $2,550. The HCRA plan offers participants the ability to pay for eligible out-of-pocket medical expenses with pretax dollars. The minimum monthly contribution for HCRA is $20 per month ($240 annually), up to a maximum contribution amount of $212.50 per month ($2,550 annually). For more information, please review the Health Care Reimbursement Brochure.

The Dependent Care Reimbursement Account offers participants the ability to pay for eligible out-of-pocket dependent care expenses with pre-tax dollars. The minimum monthly contribution for the Dependent Care Reimbursement Account (DCRA) is $20 per month ($240 annually), up to a maximum contribution amount of $416.66 per month ($5,000 annually). For more information, please review the Dependent Care Reimbursement Brochure.

As a reminder, HCRA enrollees are eligible to receive an optional Flexible Spending Plan (FSA) debit card. In 2016 health care FSA participants who have elected the optional debit card will receive an updated card, the ASIFlex Visa Card. A set of two cards will be mailed to their home and additional card sets are available for $5 which will be billed to their FSA HCRA account. The optional “ASIFlex Visa” issued by ASIFlex, allows HCRA enrollees to pay for out-of pocket medical expenses (i.e., health, dental, vision, etc.) when issued as payment at Health Care Providers and at certain retail locations that have implemented an Inventory Control System, per IRS regulations. Employees must submit the Debit Card Application directly to ASI Flex to enroll in the Debit Card. FSA claim payments began being issued daily effective August 1, 2015. Claims were previously paid only three times per month so this means, participants will receive reimbursement faster. Claims can be filed online at www.asiflex.com, through the ASIFlex Mobile Application, by fax or mail. For more information, please review the ASIflex Quick Guide and Frequently Asked Questions.

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 2016, you must submit your elections via MySJSU self service during the Open Enrollment period, which runs from September 16, 2015 at 2:00 p.m. thru October 9, 2015. 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.

MetLaw Legal

The MetLaw Legal Plan monthly premiums will increase to $21.70 from $19.70 effective January 1, 2016. MetLaw’s Legal Plan offered by Hyatt Legal Plans, Inc., provides representation for many personal legal services for employees and their eligible dependents. Participants can receive services from a Network or Out-of-Network attorney. Services for covered legal matters performed by a Network attorney are fully paid for by the plan. Out-of Network attorney fees for covered services are reimbursed based on a set fee schedule.

To learn more about this plan or to enroll, go to MetLIFE or call (800) 438-6388. 

AFLAC

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.

California Casualty

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/FERP Health Plan Changes

CalPERS is your health benefits officer. You can make changes online through my|CalPERS beginning September 16, 2015 at 2:00 p.m. through October 9, 2015. If you don't have a username and password, register now for immediate access to your account. Then follow the instructions in Changing Your Health Coverage. You can also contact CalPERS Health Benefits to make Open Enrollment changes.