The month-long open-enrollment period begins Sept. 10, during which government workers can decide whether to change or keep their existing health-care plans. The following information is provided by the California Public Employees’ Retirement System, the nation’s largest public pension fund, with a total membership of nearly 1.7 million people. CalPERS negotiates health care costs on behalf of its membership and offers information on the various available plans.
CalPERS’ Health Program Guide, available through CalPERS’ website at www.calpers.ca.gov, describes CalPERS’ basic health plan eligibility, enrollment and choices. It provides an overview of CalPERS health plan types and tells you how and when you can make changes to your plan (including what forms and documentation you will need). It also describes how life changes or changes in your employment status can affect your benefits and eligibility.
This publication is one resource CalPERS offers to help you choose and use your health plan. Others include:
–The Health Benefit Summary, which provides valuable information to help you make an informed choice about your health plan; compares benefits, covered services, and co-payment information for all CalPERS health plans.
–The Medicare Enrollment Guide Provides, which provides information about how Medicare works with CalPERS health benefits.
State employees and annuitants may enroll in the CalPERS Health Program. Annuitants are eligible retirees or their surviving family member. To enroll in the program, you must meet certain eligibility requirements.
Eligibility is based on tenure and time base of your qualifying appointment. You must work at least half-time and have a permanent appointment or a “limited term” appointment with a duration of more than six months.
If you are a state Permanent-Intermittent (PI) employee, you may enroll if you have credit for a minimum of 480 paid hours at the end of a “control period.” A control period is the six months from January 1 to June 30 or July 1 to Dec. 31.
You cannot become eligible in the middle of a control period even if the minimum hours are met. To continue to qualify for coverage, you must be credited with at least 480 paid hours at the end of each control period or at least 960 hours in two consecutive periods. Checkpoints to determine whether the hours have
been met are June 30 and Dec. 31.
Retirees are eligible to enroll in a CalPERS health plan if you meet all of the following criteria:
–Your retirement date is within 120 days of separation from employment.
–You were eligible for health benefits upon separation.
–You receive a monthly retirement allowance.
–You retire from the State, California State University (CSU), or an agency that currently contracts with CalPERS for health benefits.
The terms “family member” and “dependent” are used interchangeably. Eligible family members include:
— Registered domestic partner.
—Children (natural, adopted, domestic partner’s, or step) up to age 26.
–Children, up to age 26, if the employee or annuitant has assumed a parent-child relationship and is considered the primary care parent.
–Certified disabled dependent children over age 26.
If you are an active employee, contact your Health Benefits Officer to make all health benefit enrollment changes. Your Health Benefits Officer is usually located in your personnel office or human resources department.
Ed’s Note: For more information on open enrollment, go to www.calpers.ca.gov