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Health Benefits Eligibility

Cal Poly Pomona offers a comprehensive package of benefit programs.  Employees who meet the following criteria are eligible to participate in the benefit programs sponsored by the CSU: 

STANDARD BENEFITS ELIGIBILITY

STAFF/MANAGEMENT EMPLOYEES

  • appointed to at least half-time (.50) or more, and
  • an initial appointment duration of more than six months (six months and one day) 

FACULTY EMPLOYEES

  • appointed to at least half-time (7.5 WTU's' or greater), and
  • an initial appointment duration of more than six months (six months and one day). 

Temporary Academic Year Lecturers and Coaches

  • appointed to at least 0.4 timebase (6.0 WTU's' or greater), and
  • initial appointment duration is for at least two consecutive quarters.

AFFORDABLE CARE ACT (ACA) ELIGIBILITY

If you do not meet the standard criteria for benefits eligible employees, you may be eligible to enroll in CalPERS health benefits or FlexCash under the ACA if you meet any of the following criteria:

  • You work an average of 130 hours per month based on an annual review of computed timebase or reported hours during a 12-month measurement period, or
  • You are appointed with at least a .75 timebase or higher regardless of length of appointment (duration) or initially hired to work at least 130 hours per month.

Hours worked with any CSU campus are to be incorporated into the applicable 12-month measurement period for ACA hours and used to determine employee status. If you do not meet standard or ACA eligibility requirements and are interested in benefits offered through federal exchanges, please visit Covered California for more information.

ELIGIBLE DEPENDENTS

Eligible dependents of an eligible employee include:

  • Spouse (unless legally separated or divorced)
  • Domestic partner (registered through the Secretary of State process), and
  • 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 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 placed in the physical custody of the Eligible Employee for adoption.

GENERAL INFORMATION - All Employees

You have 60 days from the date of the eligible appointment to enroll in a medical plan.  After 60 days, an employee has the opportunity to request enrollment either as a "Special Enrollment" or "Late Enrollment" event. Late Enrollment would require a 90-day waiting period for coverage to become effective.  Special Enrollments are usually effective the 1st of the month following submission of your enrollment form to the Office of Human Resources.  Please see the Office of Human Resources for further information regarding Special or Late Enrollment events.  Employees who enroll and wish to change from one plan to another may only do so during the annual Open Enrollment period.

You have 60 days from the date of the eligible appointment to enroll in a dental plan. After 60 days, enrollment would only be allowed during the annual Open Enrollment period.

A change in the employee's family status (i.e., birth, adoption, marriage, domestic partner, death) must be reported to the Office of Human Resources within 60 days of the event to avoid delays in benefit effective dates, including a delay until the following annual Open Enrollment Period.

To enroll or make changes to your insurance plans, please complete the Benefits Enrollment worksheet and bring or send the completed worksheet to Human Resources Customer Service Center