Medical, Dental, and Vision Benefits

• Childcare support DCRA
• Employee Assistance Program
• Employee Discounts and Campus Services
• Unemployment Insurance
• Voluntary Benefit Plans

Benefits and Leaves Program Summary

Beneficiary Information Update

OptumRx Digital Tools Brochure

CSU Delta Dental: http://www.deltadentalca.org/csu/

Dental Group Numbers

Please provide the appropriate Dental Plan Group Number to your dentist from the Dental Plan Group Numbers listing.

• Dental Enhanced II PPO: Group# 04018-xxxx - Login to your Delta Dental account to print your ID card.
• DeltaCare USA Enhanced (DHMO): Group# 02034 - Please reference your ID card.

The university offers eligible employees and their dependents the choice of two dental plans:

• A "fee for service" indemnity plan in which employees choose their own dentist. (PPO)
• A "pre-paid" plan, which requires employees to select dentists from an approved list. (DeltaCare USA HMO)

Each plan varies in coverage, so it is essential that you compare plans before making your selection. Collective bargaining agreements designate the level of the dental plan for employees. Please see the latest Dental Plans Summary for a side by side comparison. Delta Dental also offers the "Delta Dental PPO Network", which may allow you to save even more on your dental care by choosing a dentist who is part of this network. The dentists in this network are a select group of Delta dentists who have agreed to charge lower fees for their services than other dentists. Generally, you will save 23 - 30% on most services. Along with your savings, you will be responsible only for your portion of the bill and you avoid having to file claim forms.

For more information, please visit the Delta Dental website to find a participating Delta Dental provider in your area.

New dental enrollments are effective the first day of the month after the forms are received in HR. For example, a new staff employee who submits an enrollment to HR on January 15th will be covered by a dental plan starting February 1st. The 60-day enrollment deadline applies. Processing at the State Controller's Office takes at least 30 days or up to two pay periods.

For academic year faculty hired at the beginning of the fall semester, coverage generally begins October 1st. For faculty hired at the beginning of the spring semester, coverage generally begins March 1st. The 60-day enrollment deadline applies in both instances. For Delta Dental enrollees, ID cards are not issued to new employees. Your dentist verifies coverage over the phone by calling your plan directly. DeltaCare USA does issue ID cards and will mail them directly to the enrollee.

Dental Employee Cost

CSU currently pays the full monthly premium for the dental plan regardless of how many dependents are covered. Co-pays and deductibles may apply.

Please Note: The IRS has ruled that the actual cost of the domestic partner benefit is taxable income to the employee. Federal income, social security and Medicare taxes are deducted monthly from the employee’s paycheck upon addition of a domestic partner to the health and/or dental plans.

Dental Late Enrollment

If you do not enroll by the 60th calendar day of eligibility, a 90-day waiting period may be applied starting from the day HR Benefits receives your enrollment form. The effective date would be the 1st of the month following the completion of the 90-day waiting period. You may also enroll during the annual open enrollment period.

Dental Plan Changes

An open enrollment period is conducted annually in the fall. At this time employees can change dental 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 dental plan. Plan changes are allowed only during open enrollment. To change your benefit, submit a completed dental enrollment form.

• 2026 Dental Plan Summary
• Dental Plan Enrollment Form
• Dental Benefit - SmileWay - Basic
• Dental Benefit - SmileWay - Enhanced
• Dental Claim Form
• Dental Plan Group Numbers

VSP website: http://csuactives.vspforme.com/

Group # 30059426 - Division # 0114 - VSP Basic Plan (Advantage Network)

Group # 30077022 - Division # 0114 - VSP Premier Plan (Choice Network)

Vision Service Plan (VSP): VSP Advantage provider Network

Convenient Customer Service Hours

VSP offers extended customer service hours, and their representatives are available Monday - Friday, 5:00 a.m. to 7:00 p.m. and on Saturday, 6:00 a.m. to 2:30 p.m. via their toll-free telephone number (800) 400-4569.

Important Requirement for Premier Vision Plan Enrollment
If an employee chooses to upgrade from the Basic Vision Plan to the Premier Vision Plan, any dependents to be covered for any Vision benefits will also need to be enrolled in the Premier Vision plan.  Employees may not split enrollments between the Basic Vision Plan and the Premier Vision Plan (e.g., dependent(s) in the Basic and the employee in the Premier).

Eligible dependents not included in the VSP Premier Vision Plan enrollment will not be able to seek services under the Basic Vision Plan coverage.

Commitment to Eye Health

VSP has developed a comprehensive Eye Health Management Program that includes: eye education, Patient Eyecare Report, Diabetes Awareness Program, communication with participants' Primary Care Physician (PCP), and Eye on Health, an annual eye wellness newsletter.

Frequency of Benefits Access Now Based on Calendar Year Perspective

All benefits eligible employees and their dependents can access vision services through VSP. The frequency of benefits will be based on a calendar year perspective, and not on a rolling basis calculated from the last date of service. For example, if an employee had an eye exam in February 2025, they are eligible for another eye exam on January 1, 2026, or thereafter.

Please view the member benefit summary and Evidence of Coverage booklet for coverage details.

Ease of Claims Processing

Claim forms are no longer required when using standard in-network benefits. Employees that choose to use a non VSP provider must submit an itemized bill to VSP in order to receive reimbursement based on out-of-network allowances. A claim form, however, is still required for Computer Vision Care benefits whether using a VSP Plan Network doctor or a non-VSP provider. Employees who meet the CSU requirement for Computer Vision Care coverage must obtain the form from the campus Benefits Office.

If you need assistance, please contact HR-Benefits at (831) 582-4426.

VSP Vision Providers

To obtain the most accurate list of vision providers, please register as a member on the http://csuactives.vspforme.com/

VSP Group Policy Number

The Group Policy number for the CSU Basic Plan is 30059426, Div. #0114.

The Group Policy number for the CSU Premier Plan is 30077022, Div. #0114.

Full details of VSP Vision plan can be found in the Evidence of Coverage booklet.

Using your VSP Benefits

Select a VSP doctor to get the best value from your VSP benefits. If your eye doctor is not in the VSP Plan Network, you still have coverage. However, it will be a lesser benefit and you will typically pay more out-of-pocket. Co-pays still apply. To view the out-of-network reimbursement amounts, please view the member benefit summary.

Make an appointment, tell the doctor's office you are a VSP member, and give them the VSP group number for the plan you are enrolled in. Please have the doctor's office verify eligibility with VSP PRIOR to your appointment to make sure your information is in their system. If there is an issue, please contact Benefits at 831-582-4426 so we may resolve any issues PRIOR to your appointment.

If eligible and using Computer Vision Care benefits, you will need to bring the Computer Vision confirmation form with you to your appointment. No other claim forms are necessary if accessing benefits through a VSP provider network.

If your eye doctor is NOT part of your VSP Plan Network:

You will be required to pay the provider in full at the time of your appointment and submit a claim to VSP for partial reimbursement. If you decide to see a provider not in the VSP provider network, call VSP first at 800-400-4569. Claim forms are available on the HR-Benefits forms page.

• 2026 VSP Vision Plan Summary
• Computer Vision Care Form
• VSP Premier Vision Plan Enrollment form
• VSP Vision Reimbursement Form

• FlexCash Plan Summary
• 2026 FlexCash Enrollment Form

This program allows CSU employees to deduct pre-tax dollars that are placed into an account to cover eligible medical/dental/vision expenses that are not covered by insurance plans. Eligible employees DO NOT need to be benefits eligible to participate in this plan.

Expenses eligible to be reimbursed from the CSU Health Care Reimbursement Account (HCRA) are expenses incurred by an employee, employee's spouse, and dependents (including domestic partner) for the diagnosis, cure, treatment or prevention of disease, and for treatments affecting any part or function of the body. The expenses must be to alleviate or prevent a physical defect or illness. Expenses solely for cosmetic reasons or expenses that are merely beneficial to a person's general health are not reimbursable. For general information, refer to IRS Publication 502 (Medical and Dental Expenses).

Initial enrollment must be made within 60 days of appointment or the qualifying event. Subsequently, employees must file a new health care authorization document every year during the annual open enrollment period to continue participation in the new plan year.

The plan year is January through December. The first tax year deduction is made from the December pay period warrant with the issue date of January. Once the plan begins, no changes can be made in the amount withheld unless there has been a qualified status change, as defined by the IRS. If contributions are stopped, employees may continue to submit eligible expenses for up to 6 months after the end of the plan year or until their account is exhausted, whichever comes first.

Any excess funds left at the end of the plan year will be forfeited. Participants will receive advance warning of this potential action from the claims administrator.

Participants in the HCRA program now have the option to pay for eligible out-of-pocket expenses via a flexible spending account debit card.  The Debit card will automatically be loaded with your annual election amount and mailed to you.

For more information about the Debit Card, including FAQs, please visit the ASIFlex website, or contact ASIFlex at (800) 659-3035.

There are multiple ways to submit a claim: Online, Mobile App, by Fax, or via Mail.

• Online - To submit your claims online, please register on the ASIFlex website.
• Mobile App - To submit claims or check account information ASIFlex’s free Self Service mobile app
• Fax - To fax your claim form, the toll-free fax number is (877) 879-9038.
• Mail - If you wish to mail your claim form, please mail it directly to the address on the form:

ASIFlex
PO Box 6044
Columbia, MO 65205-6044

Eligible Expenses

For a list of eligible over-the-counter (OTC) expenses, please see the OTC Eligible Expenses document under Related documents and forms. For a comprehensive list of eligible expenses, please visit the ASI Flex Eligible Expenses web page.

Deadline for Filing Claims

As a reminder, the CSU offers a 2 ½ month grace period extension from January 1 through March 15 for the prior HCRA/DCRA Flexible Spending Account plan year.

Participants enrolled in HCRA or DCRA through December 31st, who have any remaining funds in the 2025 plan year HCRA or DCRA account, can be reimbursed for out-of-pocket medical or dependent care expenses incurred from January 1, 2026 through March 15, 2026 If the participant re-enrolled for the current year, any claims incurred during the grace period will be automatically applied to any unused funds from the 2025 plan year (includes FSA Debit Card participants).

Participants can also request that claims incurred between January 1st and March 15th be applied to the current plan year balance rather than the prior plan year balance. Such requests must be made in writing to ASIFlex, the third party administrator.

The deadline to incur expenses during the 2 ½ month grace period is March 15th.

The deadline to submit 2025 claims for reimbursement is June 30, 2026.

After these deadlines have passed, all unused 2025 HCRA/DCRA account balances will be forfeited, per IRS regulations.

Direct Deposit Option for Claim Reimbursement

Want to receive your claim reimbursement even faster? HCRA participants have the option to sign up for direct deposit, which could get your money in your bank account the day after you fax it! (ASIFlex guarantees processing of claims the business day following receipt. Deposits are effective the banking day following processing.) Submit your completed form to the address or number provided.

Download the Direct Deposit Form: https://webdocs.asiflex.com/D_D_Forms/directdepositform.pdf 

• 2026 HCRA / DCRA Enrollment Form
• 2026 HCRA Plan Summary
• 2026 DCRA Plan Summary
• ASIFlex Card Frequently Asked Questions
• ASIFlex Quick Guide
• ASIFlex Eligible OTC Expenses
• ASIFlex HCRA Expense Planning Worksheet

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.

The CSU Employer Health Contribution Rates for 2026 have increased and are reflected below:

Please review the 2026 Health Rates Comparison Chart for specific 2025 employee premium costs.

Please Note: The IRS has ruled that the actual cost of the domestic partner benefit is taxable income to the employee. Federal income, social security and Medicare taxes are deducted monthly from the employee’s paycheck upon addition of a domestic partner to the health and/or dental plans.

Late Enrollment Penalties

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.

Understanding Retroactive Health Reimbursements

"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.

Plan Changes

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.

Find a Doctor

For the PERS Gold & PERS Platinum PPO plans, please go to the Included Health's website or contact Included Health directly at 1-855-633-4436 for assistance with locating providers for the PPO plans.

For Anthem Blue Cross' Select HMO or Traditional HMO, go to the Anthem Blue Cross website. Click on the "Menu" icon at the top of the homepage and select "Care" under the center section and select "Find Care" and select the plan you wish to find In-Network health plan providers for. 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.

Pharmacy

CalPERS has partnered with OptumRx to administer the prescription drug program for the Blue Shield of CA PERS Platinum & PERS Gold PPO plans, Anthem Blue Cross Traditional and Select HMOs, 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

Find a pharmacy

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.

• 2026 Health Rates Comparison Chart
• 2026 Health Benefit Summary
• Anthem Claim Form
• OptumRx Prescription Reimbursement Request Form
• HIPAA Privacy Notice