What do you want to do?

How do I make changes to my Health Plan?

  • Print and complete the Benefits Worksheet (MS Word, 310KB).
  • Print and complete the Declaration of Health Coverage (HBD 12-A) form (PDF, 98.7KB).
  • If adding a spouse, you will need to submit a copy of your Marriage Certificate.
  • If adding a domestic partner, you will need to submit a copy of the approved Declaration of Domestic Partnership.
  • If adding a dependent child (under 26 years of age), you will need to submit a copy of the child's Birth Certificate.
  • Submit all forms and supporting documents to Human Resources, Room 1804 of Lindero Hall, by Friday, October 6, 2017.

To get more information on CalPERS health plans and compare your health plan options, please refer to the CalPERS open enrollment materials. 

How Do I Make Changes To My Dental Plan?

  • Print and complete the Benefits Worksheet (MS Word, 310KB).
  • If adding a spouse, you will need to submit a copy of your Marriage Certificate.
  • If adding a domestic partner, you will need to submit a copy of the approved Declaration of Domestic Partnership.
  • If adding a dependent child (under 26 years of age), you will need to submit a copy of the child's Birth Certificate.
  • Submit all forms and supporting documents to Human Resources, Room 1804 of Lindero Hall, by Friday, October 6, 2017.

For information on CSU dental plans, including limitations and exclusions, go to the Delta Dental website

Enroll in Vision Premier Plan

You can enroll in the new VSP premier vision plan two ways:

  • Over thePhone: 800-400-4569
  • Online: csuactives.vspforme.com

For more information about the basic and premier VSP plans, review the VSP benefits summary (PDF, 507KB) .

How Do I Enroll or Re-enroll in Health Care/Dependent Care Reimbursement Accounts?

For more information about Health Care/Dependent Care Reimbursement Accounts go to the HCRA & DCRA Benefits page.

How Do I Elect to Participate in the FlexCash Program?

  • Complete sections 1-6 and print the FlexCash Enrollment Form (PDF, 1.2MB).
  • Sign and date the form.
  • Copy your insurance card, showing proof of insurance, and include the copy with the completed form.
  • Submit all forms and supporting documents to Human Resources, Room 1804 of Lindero Hall, by Friday, October 6, 2017.

FlexCash is an option for eligible employees who are interested in waiving their CSU health and dental coverage in exchange for a monthly cash payment. To determine whether you are eligible to participate in this program and get more information go to the FlexCash Program page.