The Foundation offers several medical plan options through a contract with the California Public Employees Retirement System (Cal-PERS). The medical insurance carriers available to Foundation employees through PERS are:
For assistance in choosing a physician or plan refer to the following website for information. http://www.calpers.ca.gov
Employees typically select their carrier based on factors such as cost, covered services, or physician network. We feel, with the variety of carriers available, you will be able to find one that suits your needs.
Each carrier sets its own monthly premium rates. The Foundation's contribution for an employee's medical insurance premium is based on the employee's enrollment category. The following rate structure does cover the quoted rates for most carriers:
| ENROLLMENT CATEGORY | FOUNDATION MAX MONTHLY CONTRIBUTION |
|---|---|
| Employee Only | $471.00 |
| Employee plus 1 | $886.00 |
| Employee plus 2 | $1,129.00 |
Employees selecting a carrier whose monthly premium is LESS THAN OR EQUAL to the employer's maximum contribution will not pay a monthly premium.
Example: A single employee selects a carrier that has a monthly premium of $423.00:
Employees selecting a carrier whose monthly premium is GREATER THAN the employer's maximum contribution will pay the difference through a payroll deduction.
Example: A single employee selects a carrier that has a monthly premium of $532.00:
As mentioned above, each carrier sets its own monthly premium rates. Please refer to the attached “Rate Sheet” to find your selected carrier’s premium rates. The rates on this sheet do not reflect the current rates for individuals who are eligible for Medicare. If you or your dependent is eligible for Medicare (parts A & B), please request a “Medicare Eligible: Rate Sheet”.
CalPERS is the contracted organization that administers the medical benefits offered by the Foundation. Although CalPERS stands for the California Public Employees Retirement System, the CSULB Foundation’s contract pertains only to medical coverage. You will receive medical ID card(s) from your chosen carrier within 3-4 weeks from the time of your effective enrollment. You may request a copy of your completed enrollment form to use as proof of coverage until your ID card(s) are received (be sure to contact your HMO carrier to determine the primary care physician and/or facility you should use before receiving your card(s) if you did not choose to designate one on your enrollment form).
Dental Insurance is provided through METLIFE. This plan offers coverage for reasonable and customary charges made by a dentist or physician for necessary dental treatment. The type of service will determine the amount of co-insurance and the deductible (refer to group plan booklet for amounts).
Preventative therapy, minor and major restoration services are limited to a maximum, per person covered, of $1,500 for the calendar year. Orthodontic treatment is limited to a lifetime maximum of $1,500 per person.
*Dental insurance premiums for eligible CSULB Foundation employees are fully paid by the Foundation. Insured employees may elect to cover eligible dependents at a contributory rate based on number of dependents and the type of coverage. Current monthly contributor rates are listed below. Rates may change due to renewal of the Foundation's insurance policies, however, employees will be notified in advance should their contributions increase.
| NUMBER OF DEPENDENTS | MONTHLY DENTAL DEDUCTION | PAY PERIOD DENTAL DEDUCTION |
|---|---|---|
| 1 | $ 17.02 | $ 8.51 |
| 2 | $ 40.46 | $ 20.23 |
** Dental Insurance Claim Form 
Vision insurance is provided through Vision Service Plan. Covered employees may utilize this diagnostic, protective, and corrective prepaid vision plan through the services of a participating provider or a non-participating provider of their choice. Although there is no deductible, employees should refer to the schedule of allowances to determine benefits
Vision insurance premiums for eligible CSULB Foundation employees are fully paid by the Foundation. Insured employees may elect to cover eligible dependents at a contributory rate based on number of dependents and the type of coverage. Current monthly contributor rates are listed below. Rates may change due to renewal of the Foundation's insurance policies, however, employees will be notified in advance should their contributions increase
| NUMBER OF DEPENDENTS | MONTHLY VISION DEDUCTION | PAY PERIOD VISION DEDUCTION |
|---|---|---|
| One | $ 1.35 | $ 0.68 |
| Two or more | $ 4.82 | $ 2.41 |
Eligible employees who also have non-Foundation coverage may elect to waive Foundation provided medical and/or dental insurance in exchange for cash. Employees who waive medical and/or dental coverage, may receive additional cash in their biweekly paycheck (not to exceed the *monthly maximum).
Waive both medical and dental = $70 per pay period (not to exceed $140 / month)
Waive medical only = $64 per pay period (not to exceed $128 / month)
Waive dental only = $6 per pay period (not to exceed $12 / month)
Life insurance is provided for eligible employees by the Foundation through Metropolitan Life Insurance Company. Eligible employees are covered under this group term plan for a principle amount equal to 2 ½ times the employee's annual salary not to exceed $257,000.00. The value of employer-provided group term life insurance coverage in excess of $50,000 is imputed taxable income to the employee (2). Employees who wish to avoid the imputed taxable income may select Basic Option 2 which provides a principal amount fixed at $50,000.
This policy provides a principal sum of the group term life insurance coverage. If, as a result of an accidental injury which occurs while insured, the employee incurs the loss of life, limb, or sight within 90 days following the injury, Metropolitan Life (MetLife) Insurance Company will pay all, or a portion thereof, of the principal sum as prescribed by the schedule of Losses and Benefits to the employee or, in the event of death, to the employee’s beneficiary.
Long term disability insurance is provided by The Standard Life Insurance Company. Long term disability serves to protect against loss of income should an employee become disabled. After an employee has been disabled for 90 continuous days he/she will receive a monthly benefit of 60% of his/her basic monthly earnings not to exceed a monthly maximum of $5,000.00. These benefits will be reduced by the amount of any State Disability or Social Security payments.
*This policy becomes effective on the 1st of the month following 30 days of continuous employment within an eligible category. Pre-existing limitations may apply
