Eligibility for Staff and Faculty

Staff

To qualify for standard health benefits you must initially have an appointment that exceeds six continuous months and one day, at a time base of at least one-half (20 hours or more per work week), however, to continue benefits you only need to maintain an appointment of at least one-half. Please view the staff overview.

Faculty

To be eligible for medical, dental and vision coverage: you must be appointed at least half-time (equivalent to 7.5 Weighted Teaching Units for academic year appointments) for more than six months. If employed in a Unit 3 Lecturer or Coach Academic Year position, employee must be appointed for at least six (6) weighted teaching units for at least one semester. Employees who do not meet the eligibility requirements listed above may qualify for health care under the Affordable Care Act (ACA).  Benefits enrollment forms will be sent to you once we confirm your eligibility.   

Note: Eligibility for retirement plan membership in the California Public Employees' Retirement System differs from the eligibility for health benefits. See the Retirement - CALPERS of this site for more information.

***If at any time your appointment with the University no longer meets the above requirements, your benefits will automatically be cancelled and you will be given the opportunity to continue your benefits by enrolling into the Consolidated Omnibus Budget Reconciliation Act (COBRA) program.

Affordable Care Act (ACA) Eligible Employees

Employees who do not qualify for standard benefit may qualify for ACA eligible health care.

One of the provisions of the Affordable Care Act (ACA) requires employers to distribute the Health Insurance Marketplace Employee Notice to all employees.

If you do not meet the standard criteria for benefits eligible employees, you may be eligible to enroll in CalPERS health benefits or FlexCash under ACA if you meet any of the following criteria:

You work an average of 130 hours per month based on an annual review of computed timebase or reported hours during a 12-month measurement period, or you are appointed with at least a .75 timebase or higher regardless of length of appointment (duration) or initially hired to work at least 130 hours per month.

Hours worked with any CSU campus are to be incorporated into the applicable 12-month measurement period for ACA hours and used to determine employee status. If you do not meet standard or ACA eligibility requirements and are interested in benefits offered through federal exchanges, please visit Covered California for more information.

Employees must complete the ACA Benefits Enrollment Form with the supporting documents and submit the forms to Benefits in Welch Hall 340.

Enrollment

The deadline for enrolling in health and dental plans is 60 calendar days from date of hire or eligibility. Employees must complete a Benefits Enrollment Worksheet and submit to the secure Benefits Services Dropbox. Enrollment in vision and life insurance is automatic for all eligible employees. Currently, there is no exclusion for pre-existing conditions. An open enrollment period for health and dental plans is usually scheduled from September to early October of each year.

Health Insurance Portability and Accountability Act (HIPAA)

HIPAA allows for "special enrollment" and "late enrollment" periods.

Special Enrollment

Allows the employee to enroll upon request, if a Declaration of Health Coverage form (Benefits Enrollment Worksheet) is not already on file. Employees have 60 calendar days from the date of the event to enroll.

• Loss of other coverage.
• Non-enrolled employees acquiring a dependent or enrolled employee's non-enrolled spouse can enroll for self and all eligible dependents.
• Court-ordered coverage.
• Marital Status change (i.e. Marriage, Divorce, Dissolution of Domestic Partnership or Certification of Domestic Partnership)

Late Enrollment

Upon request, the employee and eligible dependents can enroll after a 90-day waiting period. The 90-day waiting period commences, upon receipt of the employee's completed and signed Benefits Enrollment Worksheet along with supporting documentation. Enrollment commences at the first of the following month after the completion of the 90 day waiting period.

Continuation of Benefit Plans

If the employee or eligible dependents can no longer participate in a benefit plan due to a loss in eligibility, health, dental and/or vision plan coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA) may be continued for a specified amount of time.

Direct Pay

If you are on a Leave of Absence without Pay or are otherwise in an approved non-pay status, you may elect to continue your dental coverage by paying the full premium for your coverage via the Direct Pay method. You should complete the necessary documents prior to your Leave. Please contact Benefit Services at (310) 243 – 3771 for further assistance.

Eligible Dependents

Eligible employees may enroll themselves only, or enroll themselves and all eligible dependents (who are not otherwise enrolled as an employee, annuitant or dependent under the Public Employees' Medical and Hospital Care Act-PEMHCA).

The following family members are benefit eligible under the employee's plan:

• Spouse
• Registered Domestic Partner

Required documents for spouse or domestic partner:

• Marriage Certificate/Declaration of Domestic Partnership

• Children (Natural, adopted or stepchildren under age 26 are eligible regardless of whether or not they are be living with the employee, married or eligible for alternative coverage).

Required documents for children:

• Birth certificate(s)/temporary hospital records for newborns or adoption documents

• Children (a child other than the employee's natural, adopted or step-child, who is living with the employee in a parent-child relationship and of whom the employee has been granted custody or joint custody.

Required documents for children in a Parent-Child Relationship:

• Affidavit of Parent-Child Relationship
• Birth Certificate(s)
• Most recent income tax return or court order naming the employee/spouse as legal guardian, and/or daycare receipts/school records indicating residence at employees’ mailing address.

Note: Employee must submit the Affidavit and tax return annually thereafter up to age 26. HR Benefits will approve/deny each affidavit.

• Disabled children over age 26

Required documents for disabled children over age 26:

• Medicare Card
• Disabled Dependent Member Questionnaire and Medical Report Form

California Public Employees Retirement System (CalPERS)

• Full-time appointments that exceed six months.
• Half-time appointments (50 percent or more) for one year or longer.
• Temporary faculty are required to enter CalPERS membership commencing with the third consecutive semester appointment at half time or more or fourth consecutive quarters.
• Part time or intermittent employment is covered by CalPERS upon completion of 125 days or 1,000 hours of service within a fiscal year. 

Exclusions

• Most student employment and instructors appointed to work in extension programs.

The Part-Time, Seasonal, and Temporary Employees Retirement Program (PST)

The PST Employees Retirement Program is a mandatory retirement savings program authorized by federal law for employees who are not covered by a retirement system or Social Security. Savings Plus, part of the California Department of Human Resources, administers the PST Program for California State employees and California State University employees.

If you are a State or CSU employee who is not covered by Social Security and you are excluded from coverage under CalPERS, you are automatically enrolled in the PST Program. The program deducts a portion of your wages and deposits it in an account for you, allowing you to build retirement savings. It is set up as a 457(b) Plan, a type of retirement savings plan governed by IRS rules.

You may be excluded from membership in CalPERS if you:

• work less than half time
• are in a seasonal job
• are an intermittent or temporary employee

Contact Benefits at (310) 243-3771 if you have any questions about how you qualify for PST.

For more information, read the Part-time, Seasonal, and Temporary Employees Retirement Program Fact Sheet and the current PST Newsletter.