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Eligibility & Effective Date of Coverage

Eligible Staff, Management, and Faculty Employees

To be eligible for medical coverage:
  • An employee must be appointed at least half-time (equivalent to 7.5 Weighted Teaching Units for academic year appointments) for more than six months, or:
  • If employed in a R03 Lecturer or Coach Academic Year position, employee must be appointed for at least six (6) weighted teaching units for at least one semester, or two or more consecutive quarter terms.
  • Qualifying appointments may be either permanent or temporary.
  • Effective January 1, 2015, the Affordable Care Act (ACA) requires the CSU to offer health coverage to employees (and any eligible dependents) that work 130 hours (or 0.75 timebase) or more per month. The ACA guidelines provide for health coverage or FlexCash only. ACA does not provide dental or vision plan coverage.
  • New hire appointments that are deemed not eligible at the time of appointment will be reviewed on an annual basis. The employee will be contacted if eligible.
Once an employee has acquired eligibility and has enrolled in a plan, he/she may continue enrollment during subsequent continuous appointments of at least half-time regardless of the duration of new appointment.

Eligible Dependents

Eligible dependents of an eligible employee includes:

  • Spouse
  • Domestic Partner (registered through the Secretary of State process)
  • Dependent children from birth to the end of the month in which the child reaches 26.  A dependent child includes a stepchild, a natural child recognized by the father, or a child living with the employee in a parent-child relationship who is economically dependent upon the employee. 

Dependents who become eligible coincident with the eligible employee or upon attainment of dependent status.  Newborn infants are eligible for medical coverage from and after the moment of birth.  Adopted children are eligible for medical coverage from and after the moment the child is paced in the physical custody of the eligibel employee for adoption. 

Domestic Partners

State law allows, under specific conditions, for persons in the State of California to register non-marital relationships with the Secretary of State. This law also will recognize same-sex legal unions, other than marriage, validly formed in another jurisdiction that is substantially equivalent to a registered domestic partnership in California. Consequently, CalPERS will require information specific to the domestic partnership to determine whether or not a particular state/jurisdiction law will be recognized. Having obtained registration of the relationship, the law allows the registered individuals to obtain health benefits under the standard eligibility rules of the Public Employees' Medical and Hospital Care Act (PEMHCA). The California State University (CSU) elected to adopt the provisions of this law offering health care coverage (medical, dental and vision) for domestic partners of CSU employees and annuitants subject to the Secretary of State approval process and the CalPERS' acceptance process.  The Secretary of State Declaration of Domestic Partnership Form (DP-1) must be completed and sumbitted to the Secretary of State for approval. 

Effective Date of Coverage

  • Medical: 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. 
  • Dental: You may begin to use your dental plan when the deduction description "Delta II" or "PMI2" appears on your pay stub. 
  • Vision: You may begin to use your vision plan when the deduction description "VSP" appears on your pay stub. 

 

 

 

 


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