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Health Benefit Programs

Medical

Medical Insurance coverage for eligible Cal Maritime employees is administered by the California Public Employee's Retirement System (CalPERS). CalPERS offers a variety of plan choices.
 
There are two types of plans to choose between - Health Maintenance Organizations (HMOs) and Preferred Provider Organizations (PPOs).

An HMO offers members a range of health benefits, including preventive care, for a monthly fee, with no deductibles or maximums, and minimal co-payments. You will need to choose a primary care physician (PCP) within a network of contracting doctors. The PCP coordinates all your care, including referrals to specialists, when necessary. If you go outside of the HMO without a referral from the plan, you'll be responsible for the total cost of services, except for emergencies or urgent care services. HMOs are available only in designated California services areas.
 
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. You may choose to use a doctor outside their network, but you will pay a higher co-payment. These plans are available statewide and outside of California.
 
Unlike an HMO, where a primary care physician directs all your care, a PPO allows you to select a provider and a specialist without referral. There are annual deductibles to meet before the plan will pay benefits and you are responsible for a certain percentage of the charges (co-payments). The plan pays the balance up to the agreed-upon amount. The covered benefits vary by plan.
 
Please refer to each plan's Evidence of Coverage (EOC) booklet for the exact terms and conditions of coverage. In case of a conflict between this summary and your plan's EOC, the EOC booklet determines the benefits that will be provided.
 

Comparisons, Rates and Providers

Forms

 
Effective Date of Coverage: If you enroll on or before the last day of the pay period in which you are appointed, the effective date of medical coverage will be the first day of the following month.
 
Enrollment Period: You have 60 calendar days from your appointment date to enroll in benefits.
 

Dental

 
Eligible Cal Maritime employees may enroll themselves and their eligible dependents in dental coverage, with premiums currently paid in full Cal Maritime.  For information regarding eligible dependents, see the CalPERS Guidelines for enrolling family members.
 
Eligibility
 
Employees are eligible if appointed half-time or more for a period of more than six (6) months.
 
Lecturers and Coaches appointed for a minimum of one semester or two consecutive quarters at .4 timebase or greater are eligible for benefits. Coaches (Non-academic calendar year) and Lectures (12 month appointments) are eligible for benefits if appointed half-time or more for a period of more than six (6) months. Exclusions: Faculty appointed solely to teach summer session, extension or intersession are not eligible for benefits. 
 
Employees appointed on an hourly, intermittent basis do not qualify for benefits.
 
To enroll, you must complete the Benefits Enrollment Worksheet along with any required documentation for eligible dependent(s) and return to Human Resources. The deadline to enroll is 60 calendar days from date of eligibility.You may begin to use your dental plan when the deduction description Delta II or PMI 2 appears on your pay warrant stub.
 
Two plans are available: Delta Dental (PPO Program) and DeltaCare USA (Pre-paid Dental Maintenance Organization Plan). For details, please see the Delta Dental CSU website
 
Plan Information:
 
Delta Dental PPO (Group Numbers 4018 and 4918)
 
Delta Care USA (Group Number 2034) - Available to CA Residents Only
 
 
For a side-by-side comparison, please review the program overview for the two plans. 
 
 
You can select FlexCash ($12 a month) if you wish to waive the CSU dental coverage because you have other non-CSU Coverage.

Vision

 
All eligible Cal Maritime employees and their dependents are automatically enrolled in the Vision Service Plan (VSP).
 
Group Plan Number #: 30059426 (effective January 1, 2016). 
  • Premiums are paid by the CSU
  • May visit any licensed ophthalmologist, optometrist, or dispensing optician of choice
 
Vision Plan Benefits
  • One comprehensive eye exam every calendar year
  • One pair of lenses ever other calendar year (or calendar year if your prescription changes) and one frame every other calendar year.
  • Contact lenses every other calendar year when contact lenses are provided in lieu of all other lens/frame benefits
  • The VSP Computer Vision Care (CVC) is only provided to CSU employee who meet the necessary job requirements as determined by the CSU campus benefits office.  This form must be completed by the employee and provided to a VSP Select Network doctor to receive the supplemental CVC benefit.  
  • In-network frame allowance: $95
  • Out-of-network frame allowance: $60
  • In-network contact lens allowance: $120
  • Polycarbonate lenses are covered for dependent children in-network up to age 23, instead of age 12; and
  • Discounts of approximately 15% for laser correction surgery are available
 
For more detailed information about what the plan covers:
 
VSP Online Access
 
Employees can complete an online member registration enrollment to create a user identification (ID) and password, for the purposes of viewing his/her vision benefits at www.vsp.com.  VSP will require the employee's SSN to verify eligibility.  

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