Cal Poly Pomona

Employee Benefits Enrollment Information Folder


For Benefits Eligible Employees in Units 2, 5, 7, and 9 (California State University Employees Association--CSUEU). If you have an appointment that makes you eligible for benefits, you have 60 days from the date of your appointment to enroll into benefits. Please attend our monthly benefits orientation and/or call the Benefits Office at 909-869-3734 or 3735 for further information.

Health & Dental Benefits
Health Benefits Enrollment Form
Dental Benefits Enrollment Form
Vision Care Benefits Enrollment Form
Pharmacy Benefits Automatically provided for employees enrolled in one of the four health care plans
Mental Health Benefits Automatically provided for employees enrolled in one of the four health care plans
Reimbursement Accounts Enroll Online
Retirement Plans
Retirement Plan Enroll Online
Educational Benefits
Employee Tuition Assistance Enrollment Form
Children's Tuition Grant Application
Financial Security Benefits
Voluntary Disability Enrollment Form
Supplemental Life Insurance Enrollment Form
Personal Accident Insurance Enrollment Form
Universal Life Insurance Enrollment Form
Personal Casualty Insurance To enroll, please contact Marsh@WorkSolutions at 1-800-552-9670 or visit the Marsh@Work Solutions Personal Plans web site for additional information. Representatives are available Monday - Friday, 8 a.m. to 6 p.m. EST.
Long Term Care Insurance Enrollment material is available at the Aetna website or by calling Aetna's customer service line at 1(800)287-9145 Monday through Friday from 8 a.m. to 8 p.m.






Life Insurance

Group Long Term Disability Insurance



Pre-Tax Savings/ Investments for Retirement

Flexible Spending Accounts

Voluntary Insurances

Benefits Enrollment
Information Worksheet