Health

• Medical Insurance Plans
• Dental Insurance Plans
• Vision Plan

• Tax Advantage Premium Plan (TAPP)
• Flexcash Program
• Health Care Reimbursement Account (HCRA)
• Dependent Care Reimbursement Account (DCRA)

• Affidavit of Marriage (.pdf)
• Affidavit of Parent-Child Relationship (.pdf)
• Benefits Worksheet: (.xls) | (.pdf)
• CSU Privacy Policy (.pdf)
• Declaration of Health Coverage (.pdf)
• Domestic Partner Dependent Certification Form (.pdf)
• Employer Zip Code Election (.pdf)
• Flex Cash (.pdf)
• Gender Verification of Married Persons (.pdf)
• HCRA/DCRA Enrollment Form (Effective 2013) (.pdf)
• HCRA/DCRA Claim Form(.pdf)
• VSP Out-of-Network Reimbursement Form (.pdf)
• VSP Video Display Terminal (VDT) Confirmation Form (.pdf)

Open Enrollment
An annual open enrollment period each Fall allows employees to enroll in or make changes to health plans. For more information about 2013 health plan changes, read the CalPERS Open Enrollment Website and view the 2013 Health Plan Rates.

COBRA
Consolidated Omnibus Budget Reconciliation Act (allows eligible employees and dependents to temporarily continue health benefits coverage under certain conditions)

Retiree Health (Medical and Dental)
CSU post-retirement medical and dental benefits are available to employees (and their eligible dependents) who retire within 120 days from the date of separation from employment. More information.

More detailed information appears in the certificates of insurance, applicable booklets and brochures, and relevant collective bargaining agreements/technical letters, including the full text of definitions, exclusions, limitations, reductions and terminating events that apply to your coverage. This summary does not modify those provisions or the insurance in any way.