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DATE: August 13, 2003
TO: All Benefits Eligible Employees
FROM: Yasuko Shirakawa, Benefits Coordinator
Human Resources & Equal Opportunity
SUBJECT: 2003 CalPERS Open Enrollment Period
The annual open enrollment period for CalPERS Health, CSU Dental, Dependent Care Reimbursement Account (DCA), Health Care Reimbursement Account (HCRA), and FlexCash plans will be held September 1 through October 31, 2003. The effective date for all changes made during open enrollment will be January 1, 2004. Please note the following information and 2004 contract year plan changes below:
· CalPERS will continue to offer two PPO plans PERS Choice and PERS Care, and Blue Shield HMO and Kaiser Permanente for its HMO plans. There will be no changes to current health plans through December 31, 2004.
· Premiums for the basic HMO plans will increase an average of 18.0% and PERS Choice and PERS Care premiums will increase an average of 13.0%. Some of this additional cost will be borne by the University, however, enrollees may see an increase in their premium rates, depending on their health plan and number of dependents covered. Please see the attached 2004 premium rate sheets for specific contribution rates. These new employee contribution rates will be reflected in the December 2003 pay warrant. Use the links to Premium Rate Sheets at the bottom of this page.
· CalPERS will send each health plan member a personalized “Health Plan Statement” that will include their current health plan, dependents enrolled, and zip code (home or work) currently used to determine health plan eligibility. The statement will also provide health plan premiums and benefits changes for 2004 and a prepaid postcard for ordering Open Enrollment information. The postcard must be returned by October 10, 2003 for the member to receive the requested materials prior to the close of Open Enrollment. If you do not wish to change to another plan and all of your enrollment information on your Health Plan Statement is correct, you do not need to do anything during Open Enrollment.
· Emergency room co-payments for Blue Shield and Kaiser will increase to $50 per visit (waived if admitted) in order to standardize emergency room co-pays across all HMOs.
· The co-payments for non-formulary drugs will increase from $30 to $45 for retail and from $45 to $75 for mail order for all plans, except Kaiser. The $1000 out-of-pocket maximum for mail order drugs continues to apply. In limited situations where medical necessity requires a member to take a non-formulary drug, the member will be able to request a medical necessity exception to the increased non-formulary co-pay. If the exception request is approved, members will pay the $30/retail or $45/mail order co-payment for the non-formulary drug.
Note: The member must coordinate with their doctor to request a medical necessity exception using the procedure specified by their plan. The exception request procedure will be described in each plan’s 2004 Evidence of Coverage (EOC) booklet. The 2004 EOCs will be mailed to all current members no later than October 1.
For more information, please visit the CalPERS website www.calpers.ca.gov or contact the Benefits Office at ext. 4425 or ext. 4412.
To view your current benefits coverage go to the CSUSM Home Page: http://www.csusm.edu/
Click on the "my.csusm.edu" link
Sign-in using your csusm User ID and Password
On the Portal Menu Click on "My HR Information"
Click on "View My Benefits"
Staff/Faculty/MPP/Confidential 2004 Premium Rate Sheet
Unit 6 2004 Premium Rate Sheet
Benefits Worksheet (MS/Word Doc used by an employee to inform HR of which
Benefits choices they have made)
Printing instructions:
Print on pink paper only
Complete entire first page only
Original hardcopy with signature must be received in HREO - electronic copies are not accepted
For questions please call Yasuko Shirakawa at (760) 750-4425.