Health Insurance

HMO

Health Maintenance Organizations

An HMO offers health benefits, including preventive care, with no deductibles or maximums, and minimal co-payments.

You will choose a primary care physician (PCP) within a network of contracting doctors.

PPO

Preferred Provider Organizations

A PPO is a form of managed care, but it is more similar to a traditional "fee-for-service" type plan.

PPOs contract with doctors, hospitals, and other providers to provide services for an agreed-upon charge.

Rate Comparisons

Health Plans are administered by the California Public Employee's Retirement System (CalPERS) calpers.ca.gov

Please refer to each Plan’s Evidence of Coverage (EOC) below for the exact terms and conditions of coverage. In case of a conflict between the summaries provided on this page and the Plan’s EOC, the EOC determines the benefits and coverage.

HMO Monthly Rates 2017
Anthem Traditional Blue Shield Access + United Health Care
1 Party $165.91 $123.44 $0.00
2 Party $396.82 $311.88 $23.34
3+ Party $542.57 $432.14 $57.04
PPO Monthly Rates 2017
PERS Select PERS Choice PERS Care PORAC*
1 Party $0.00 $33.88 $119.37 $0.00
2 Party $0.00 $132.76 $303.74 $118.00
3+ Party $23.45 $199.29 $421.56 $149.00

Cal Poly's 2017 monthly contribution: 1 Party-$707; 2 Party-$1,349; 3+ Party-$1,727
Bargaining Unit 6, SETC (Trades), pay slightly less: -$5.00/-$10.00/-$20.00
*Bargaining Unit 8, SUPA (Police) only, may enroll in PORAC

Prescription Information

Vendor Website Phone Description
CVS Caremark caremark.com 866-346-7200 Pharmacy manager for Blue Shield Access+ HMO
OptumRx chp.optumrx.com 855-505-8110 Pharmacy manager for all other plans (PERS Choice, PERS Select, PERS Care, United Healthcare HMO, and Anthem Traditional HMO)

FlexCash Plan

The CSU offers two plans that help employees manage their benefit needs and save valuable tax dollars. If an employee has medical and/or dental coverage not offered by the CSU, Medi-care, Medi-Cal, Tri-Care or California Care, the FlexCash Plan pays cash in lieu of CSU coverage, allowing the employee to receive only the coverage needed. If an employee elects health coverage through the CSU, the Tax Advantage Premium Plan (TAPP) allows for the payment of health insurance premiums on a pre-tax basis, reducing federal, state and FICA taxes.

If an employee chooses to participate in FlexCash, the following monthly after-tax payments are made to the employee:

Benefit Waived Payment
Medical and Dental $140
Medical Only $128
Dental Only $12

Health Plan Premiums are deducted pre-tax

Health premiums are deducted from your paycheck on a pre-tax basis through the CSU Tax Advantage Premium Plan (TAPP). All employees are enrolled automatically into TAPP. If you prefer to pay your premiums on an after-tax basis, please contact Human Resources.

Medicare

Active employees and/or their spouses/domestic partners who become Medicare eligible at age 65 and are currently enrolled in one of the CSU group health plans do not need to enroll in Medicare before retirement. There will be no penalties assessed to these employees and/or their dependent spouses/domestic partners when they elect to enroll later. You may enroll in Medicare Part A (Hospital). (See "Special Enrollment Period" on the Social Security website by viewing the Medicare Enrollment Flyer.)

If retired, at age 65, by law, you must enroll in both Part A (hospital) and Part B (medical) of Medicare in order to maintain your eligibility for health benefits under CalPERS. Enrollment is not automatic, and the retiree must contact Social Security directly for enrollment information.

Note: FERPs are retired, and therefore must enroll themselves and/or their 65-year-old spouses/domestic partners in Medicare.

The Evidence of Coverage Publications for the Medicare Health Plan Supplements can be found on CalPERS Plans and Rates.

Benefits

DocuSign Benefits Forms

The benefit forms located below can now be submitted online through Docusign. Please click on the desired link to begin the process. Additional information regarding Docusign can be found on the Cal Poly ITS webpage: Service Desk Website