Human Resources

Initial health enrollments are generally effective the 1st day of the month following the date the enrollment form is received by HR. The enrollment form must be signed and submitted within 60 days from the date of your qualifying appointment.

For academic year faculty appointed at the beginning of the Fall semester, coverage begins on October 1st provided that the above-mentioned enrollment procedures are followed. The earliest effective date for faculty hired Spring semester is March 1st.

Please note: Enrollment processing generally takes about two to three weeks to complete. This processing lag does not affect your coverage effective date. You will receive ID cards directly from your health plan within 10 days from when they receive the enrollment data from CalPERS. If you need to see a health provider before you receive your medical ID cards, please contact HR Benefits for your plan's Group# and call the appropriate insurance company for your Member ID#.

You may be asked to pay your doctor or pharmacy bill up front without an ID card. You should keep your receipts and submit a reimbursement claim form to the carrier. These forms are available on the HR forms page. If you do not receive your ID card after six weeks, please contact the insurance provider directly and inquire on the status of your ID card(s). If you need additional assistance, please contact HR Benefits.

CSU makes a substantial contribution toward the monthly gross premium cost. The employee is required to pay the difference (if any) between the CSU's contribution and total premium as shown in the CalPERS Basic Plan Rate Comparison chart. Any out-of-pocket costs for monthly medical premiums will be automatically deducted from your paycheck on a pre-tax basis. Premiums and out-of-pocket costs are adjusted annually on January 1st.

You may also have co-pays and deductibles depending on your plan.

If you do not enroll yourself and all eligible dependents when you first become eligible, you will have to wait 90 days from the HR received date or for the next open enrollment period to enroll.

"Retroactive transactions" can happen when your eligibility status, or the eligibility of one of your dependents changes (i.e., divorce, death, marriage of your child under age 26, etc.), and those changes are not reported in a timely manner. That means there is an "overpayment" of your premiums - by you and your employer - which can be reimbursed; however, there is a limit to the time period the reimbursement covers.

An "Open Enrollment" period is conducted annually in the Fall. At this time employees can change health plans, and add or delete dependents. Changes are effective on January 1st of the following year. Employees are advised to carefully consider all factors when choosing a health plan. CalPERS only allows plan changes during Open Enrollment or in the event of an address change.

Please notify HR if you move out of a zip code because this may affect the availability of your health plan.

For Anthem Blue Cross' EPO, PERS Platinum,  PERS Gold, Select HMO and PORAC enrollees, go to the Anthem Blue Cross website. Click on the "Menu" icon at the top left of the homepage and select "Find Care" under the center section entitled "Care" and select the plan you wish to find In-Network health plan providers for. 

For Blue Shield HMO enrollees, go to the Blue Shield website and click on "Find a Provider".

For websites for other providers, please refer to the Benefits Contact Information webpage.

On the websites, you have the option to become a registered user and obtain individualized information regarding your account at your convenience.

CalPERS has partnered with OptumRx effective January 1, 2017 to administer the prescription drug program for the Anthem Blue Cross EPO, PERS Platinum, PERS Gold, Anthem Blue Cross Traditional and Select HMOs, Health Net SmartCare, PORAC, and UnitedHealthcare medical plans. By becoming a registered user on the OptumRx website, you can:

• refill and renew mail order prescriptions
• enroll in Hassle-Free Fill
• check order status
• review pharmacy benefit plan highlights
• compare prescription drug pricing
• find a pharmacy
• and more!

By registering on the OptumRx website, you will be able to locate a pharmacy near you. You may be asked to provide the following information:

• the member's ID number found on your medical ID card. The medical ID number is 9-digits long and does not include the first three letters.
• the member's date of birth, and
• the zip code or city

You may also contact OptumRx customer service for further information at (855) 505-8110.