Benefits Summary Sheet

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1 Human Resources Management 1000 E. Victoria Street WH C-495 Carson, CA (310) FAX (310) Benefits Summary Sheet Important!!! Please read the following information carefully and completely. Keep this for future reference. MANY of your benefit related questions can be answered on this sheet. Who is eligible to receive benefits? Faculty who are considered full-time, tenure track, temporary faculty with a full academic year contract AND a minimum of 7.5 units per semester or grandfathered faculty (meaning those hired in , and had benefits at that time) with 6 units or more per semester are benefits eligible. Effective July 1, 2002, lecturers or coaches in academic year classifications who are appointed for at least six (6) weighted teaching units (i.e., 0.4-time base), for at least one semester are benefits eligible. Staff who are hired either into a probationary-permanent position or a temporary position with a time base of half time or more with an appointment over 6 months (it can not be an accumulation of short-term appointments) are benefits eligible. What are my options regarding benefits? Medical You have the option of electing 1 of the 5 participating medical plans. There are 2 different HMO s and 3 PPOs. You will be issued ID cards from the carrier once your information has been processed. Participating carriers are as follows: Kaiser PERS Choice - PPO Blue Shield HMO PERSCare PPO PORAC (for our public safety officers only) There is a CalPERS Health Program packet enclosed in your benefits orientation package. In book #2 there are comparison charts outlining what the HMO plans cover and what the PPO plans cover. Dental Delta Premier or PMI DeltaCare are the dental plans available. Delta Premier is similar to a PPO (preferred provider organization) whereby you have the option of seeing an in network or out of network dentist. There are three levels of coverage. The level of coverage receive depends upon the job classification. No ID cards will be issued. You would give the dentist your group ID number and social security number. The PMI DeltaCare plan is comparable to an HMO (health maintenance organization) in the sense that you select and must go to that particular dentist for services. You may not go to a non-participating dentist. Once your application has been processed, you will be mailed ID cards. To find out if your dentist is within that network or to find a Delta dentist near you, you may access Delta s web page address at Vision We have one vision, CPIC, administered by Medical Eye Services. With this plan, you may go in or out of network. However it is to your advantage to go to a participating eye doctor, as the insurance will cover more of the out of pocket cost. Please refer to the back page of the lavender brochure for services insurance will cover. There is a mandatory $10.00 co-payment at the time of the examination. A provider directory has been provided to you in your orientation package. You have been given claim forms that do not need completion until you visit your eye doctor. The group number and telephone number for member services are on the claim forms. You will receive no ID cards. How much will this cost me?

2 The only amount an employee will pay toward premiums will be for medical benefits. Premiums for dental and vision are paid for by the University 100%, this would exclude any co-payments, deductibles or services rendered above and beyond what the insurance pays for. Contribution rates are subject to change annually. A rate sheet has been included in your orientation package as well as listed in the University web page under Human Resources, Benefits at How do I sign up? First you must complete a Health, Dental and Vision Benefits Worksheet (enclosed in your packet). However, at this point the enrollment process is NOT done!! Next, if you elect an HMO, you must indicate a physician ID code. By doing this, you are assigned to a doctor of your choice; otherwise one is assigned to you. You may obtain the physician s ID code by checking the website of the carrier. We also have most of the directories in print in Human Resources. If you select PMI DeltaCare as your dental carrier, please be sure to designate which dental office you would like to be assigned to. Their dental directory will have coding information. Then, your information is reviewed for completeness. There are two additional forms that require your review and signature. Lastly, once we have the two forms signed in our office, THEN the enrollment process is done. So, when do my benefits begin? An employee who has met the qualifications for benefits eligibility may become benefits eligible for medical benefits the first day of the month following completion of their enrollment process. (New faculty members are not benefits eligible until they begin to receive a paycheck.) Dental and vision benefits, become effective the first month after the medical benefits go into effect. Newly hired employees have 60 days to enroll into benefits otherwise they are considered late enrollments, resulting in a mandatory 90-day wait after the request for benefits is received. How do I begin to use my benefits? The CalPERS Health Benefits Division and the State Controller s Office are the state agencies based in Sacramento that process benefits. After your information is received in Sacramento, it may take anywhere from 1-3 months for your information to be entered into the state system, then routed to the appropriate carriers. When you see employer contributions toward benefits being made for you on your pay stub, you can be assured that your information has been entered into the state s system. You will receive a copy of your intent to enroll for benefits, please keep this in a safe place. Should you or any of your eligible dependents need medical care, you may contact the doctor and show your copy of your intent to apply for insurance as evidence of your insurance. The doctor may require that you sign a waiver in the event you are not covered accepting financial responsibility for services rendered. What if I don t like the carrier(s) I selected, when can I make a change? If you are in an HMO, you may make changes from month to month WITHIN the carrier group. Only during open enrollment (or if separating from employment) can you change from one carrier to another. Open enrollment is held once a year, typically beginning September 1st through October 15th. However the change will not be effective until the first of the following year. Are there any other employer paid benefits? Death benefits are payable to the named beneficiary upon the death of an active or retired CalPERS member. The amount varies depending on the employer s contract and the member s job classification and years of service. There is a $5000 death benefit, refund of retirement contributions plus interest, as well as 6 months salary payable to your beneficiary if the employee was not eligible to retire at the time of death and had less than 20 years of service (for more than 20 years it would be $5000 only as well as retirements contributions.) If the employee WAS eligible to retire, then there would again be a lump sum $5000 death benefit, and the option of receiving the above mentioned benefits or receiving a lifetime monthly allowance equal to the amount the employee would ve received. As a retiree the death benefit goes to $2000. Life Insurance Policy and Accidental Death and Dismemberment This employer-paid insurance is available to members the following employees executives (150k), management (100k), confidential (50k), faculty/unit 3 (50k)

3 teaching associates (50k), unit 4 (25k), Public Safety/unit 8 (10k), and CSEA/units 2,5,7, & 9 (10K). There is a long-term disability benefit for active faculty, executives, management position levels and unit 4. EMPLOYEE ASSISTANCE PROGRAM (EAP) This program offers confidential counseling and referral service to help you and your family member(s) deal with life s daily challenges. The University is paying for this benefit. This benefit is available to all employees except those in unit 4 (Academic Professionals of California.) What about a retirement plan? Enrollment into one of three retirement plans ( CalPERS, PST, or UC/DC) is automatic and mandatory. There are NO employer contributions. Contribution rates by employees vary depending upon the retirement plan the employee qualifies for. For those who qualify for CalPERS there are a 5% of funds in excess of $513 of your income that is placed in a retirement account for you until you are ready to retire or separate from all state employment. Factors used to determine your retirement benefit for CalPERS members are based upon age, years of service and an average of your highest 12-month income. A chart giving a rough estimate of percentage received into retirement may be obtained in HR. You may also access the CalPERS Government web page at to receive additional information regarding compensation into retirement. Once a year you will receive a statement from the California Public Employees Retirement Systems (CalPERS) as to your total funds on account. For information on the PST plan please log on to or for UC/DC please log on to Social Security Employees who are members of PERS are covered under Social Security. The University and the employee both contribute into the employee s account. Additional (Retirement) Contributions Program This program allows PERS members to contribute after-tax funds into an account to be invested by CalPERS. These contributions, plus interest, are available in a lump sum upon retirement or separation. What other benefits are offered? The following is a brief description of optional benefits. Please pay close attention to those plans that have time limits to apply. A+ Auto & Home Insurance plus offered by California Casualty Offers low rates negotiated exclusively for university employees. You may call them at for your free, no-obligation quotation or visit their web site at CalPERS Long-Term Care Program This offers long-term care to all staff, retirees, and their siblings (age 18 and older), spouses, parents, parents-in- law. The only time to sign up for this plan is during the annual Application period. It usually takes place between April and June, however this may vary and exact time will be announced. For more information, you can call them at (800) or visit their web site at CalPERS Member Home Loan Program This program offers assistance in applying for home loans, financing, rate information, refinancing and more. You may visit their web site at Dependent Care Reimbursement Account (DCRA) This plan offers a way to reduce your taxable income which allows you to pay expenses from your salary before income tax is withheld for dependent care. Newly hired employees may enroll in the plan within 60 days. Enrollment forms may be obtained in Human Resources. All other employees may apply for this plan during the general open enrollment period, beginning in September.

4 Employees need to re-enroll for this plan every year to have the deduction continue. Once employees elect to participate in this plan, they may not cancel during the year unless they meet the requirements mandated by IRS. Health Care Reimbursement Account (HCRA) This plan offers the ability to pay for eligible out-of-pocket health care expenses with pre-tax dollars. If you enroll in the plan, the contributions are made prior to federal, state and Social Security taxes. Newly hired employees may enroll in the plan within 60 days. Enrollment forms may be obtained in Human Resources. All other employees may apply for this plan during the general open enrollment period, beginning in September. Employees need to re-enroll for this plan every year to have the deduction continue. Once employees elect to participate in this plan, they may not cancel during the year unless they meet the requirements mandated by IRS. Fee Waiver The Employee Fee Waiver and Reduction Program is a benefit for eligible employees of the CSU system. It allows eligible employees to participate in CSU general fund courses at reduced rates and waiver of some fees. In most cases an employee may enroll in a maximum of two courses or 6 units, whichever is greater, per semester or quarter. As defined in the collective bargaining agreements (CBA), an employee may transfer the fee waiver and reduction benefit to a spouse, registered domestic partner or dependent child. Courses taken by employees can be taken under the Career Development Plan (pursuing a degree) or as Job-related (to enhance current position.) Spouse, domestic partner or dependent child must be matriculated toward a degree or the attainment of a teaching credential in the CSU. You may obtain an application form at FlexCash- If you have medical and or dental coverage outside state employment, you may elect to waive the CSU coverage and receive a monthly monetary benefit of up to $ a month. Applications may be obtained in Human Resources. Newly hired employees may enroll in the plan within 60 days. All others may apply during the general open enrollment or they may enroll if they have met one of the criteria mandated by IRS. Mid-Cities Schools Credit Union You may apply for membership if you are employed by certain public school districts including Cal State University Dominguez Hills. For more information please refer to the brochure in your benefits packet. You may contact Mid-Cities Schools Credit Union at (310) Standard Life Insurance Should you decide you would like additional life insurance, newly hired employees have 60 days to enroll in this plan. If you apply outside the 60-day period, you may be asked to submit a medical questionnaire and your application will be subject to review. You may visit their website at Ocean Crest Credit Union formerly Long Beach Credit Union. Employees of the state and retirees are welcome to join. Memberships are lifetime. You may obtain more information in Human Resources Management or by accessing the home page at Sanders & Associates Offers a variety of insurances including disability and travelers assistance. Newly hired employees have a 30-day open enrollment period. All others may apply outside this period, however a medical questionnaire would be necessary and the application would then go through a review process. For more information, please refer to the brochure included with your benefits package. You can visit their website at or call them at (800) Savings Plus Program 401 (k) & 457 plans are retirement savings plans on a tax-deferred basis. Applications are housed in Human Resources. An employee may join at any time. You may visit their website at Tax Sheltered Annuity TSA 403(b), is a retirement saving plan on a tax-deferred basis. Applications and vendor listings are housed in Human Resources. An employee would first need to set up the account prior to completing the salary reduction agreement. An employee may apply at any time. You can obtain a Salary Reduction Agreement from the Human Resources Office or by visiting our website at you can also access the following website for a listing of the current companies US Savings Bonds You may purchase bonds through payroll deductions. You may apply at any time. Applications to begin payroll deductions may be obtained in Human Resources. For more information on Savings Bonds you can visit their website at or call (800) 4US-BOND.

5 Holidays CSU, Dominguez Hills observes 13 holidays and one Personal Holiday each year. Holidays falling on a Saturday are usually observed on the preceding Friday. Holidays falling on a Sunday are usually observed on the following Monday. Sick Leave Eligible full-time employees earn eight hours of sick leave per month, with unlimited accumulation. Part-time employees earn on a pro rata basis. Personal Holiday All eligible employees are entitled to one Personal Holiday per year. It must be used by December 31 of each year or you will lose it. Vacation Eligible full-time employees accrue vacation time according to years of service. See the appropriate Memorandum of Understanding (MOU) for details. Part-time employees earn on a pro rata basis. Industrial Disability Leave (IDL) - This insurance plan is paid by the University. It provides payment for employees who suffer an illness or injury related to their work with the University. Non-Industrial Disability Insurance (NDI) This insurance plan is paid by the University. It provides income for employees who are PERS members who suffer a wage loss as a result of an injury or illness that is not work related. Unemployment Insurance This employer-paid program is designed to provide income assistance for employees in the event of job loss. Entertainment Discount Cards Discounts are available for most local attractions. Do you still have questions? Please contact the Benefits Coordinator at extension Cal State University Dominguez Hills Benefits Summary Sheet revision date 07/2003

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