Health Benefits

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HSU Health Benefits include Medical, Dental, and Vision coverage, along with other several benefit options such as Flex Cash and Health Care and/or Dependent Care Reimbursement Accounts.  Scroll down to learn more.

Available health plan options may vary depending on the employee’s county of residence. You can search for available health plans by zip code here:

If you are interested in using an out-of-area residence for plan eligibility, please contact the Human Resources office.

Medical

HSU employees have several health plans from which to choose. Each plan varies in coverage and premium cost, therefore, it is essential that employees compare each plan against personal and family needs prior to making a selection. The State pays a portion of the premium and the balance is deducted from enrolled employee's payroll warrants.

Eligibility for core benefits: Half-time or more in an appointment that exceeds six months in duration for all employees except part-time lecturers. Part-time lecturers and coaches appointed for one semester for at least 6 WTU’s (0.4 time base) also qualify for health coverage.

Employees must enroll in a health plan within the first 60 days of eligible employment, or serve a 90-day waiting period after enrollment before coverage begins, or wait for the next open enrollment period.

IMPORTANT: Effective July 1, 2005, a new regulatory change limits CalPERS premium reimbursements to six months for members and dependents whose ineligibility to health benefits is not reported within that time.

Members who fail to report changes in their health enrollments in a timely manner could be liable to reimburse their employer for the state share of premiums that continue to be paid to a CalPERS health plan on behalf of an ineligible member or dependent.  To report such changes in your eligibility status or the eligibility status of your dependents, please notify Human Resources within 60 days of the event.

HMO (Health Maintenance Organization) Plans

A Health Maintenance Organization (HMO) requires you to receive care through a network of providers.  You must select a primary care physician, who is responsible for coordinating your health care, including referrals to specialists.

Our current HMOs, Blue Shield Access+ and Anthem Blue Cross Traditional HMO, offer equivalent coverage with the only difference in monthly premiums, and possible slight differences in medication coverage. You may view these rates on the 2017 Benefits Rate Sheet

Our HMOs have no annual deductible and office visit co-pays are $15. In addition, emergency room visits are $50. Should a member of the HMO need to seek higher or more specialized medical care, we have access to UCSF Medical Center and Stanford Medical Center at the same $15 co-pay.

An HMO network is limited to the plans contracted providers and members must designate a Primary Care Physician (PCP). Once a PCP is designated, an employee must see that doctor. Office visits with a physician not designated as your PCP will not be covered, unless you are receiving care at an emergency room or urgent care facility. You may change your PCP up to once a month.

The Humboldt Independent Physicians Association (IPA) works with our HMO plans and can assist you in finding health care providers. Please confirm with doctor's office before selecting any physician to serve as your primary care designation.

Anthem Blue Cross Traditional HMO Plan

  • Find a provider, check your claim status, and other resources for Anthem Blue Cross Traditional HMO members.
  • Summary of Benefits, Evidence of Coverage, and Welcome Guide. Select “Plans for Traditional HMO, Select HMO.”

Blue Shield Access+ HMO Plan

CalPERS PPO Plans

A Preferred Provider Organization (PPO) allows you to choose from a network of preferred providers.  A primary care physician is not required and referrals are not necessary for other in-network providers. You pay more to use an out-of-network provider. Members of PPO plans are also subject to an annual deductible.

Our current PPOs offer slightly different coverage. However, all three have an individual deductible of $500 and a family deductible of $1000. Office visit co-pays are $20. Employees in a PPO plan do not need to designate a Primary Care Physician.

IMPORTANT:  Any services received at out-of-network providers or hospitals for all three PPO plans are reimbursed at the 60/40% rate, which means that the health plan will pay only 60% of the rate that is contracted with providers in their network.  All non-allowable expenses are the responsibility of the member which means significantly higher out-of-pocket costs.

PERS Care: Once the deductible is met, Anthem Blue Cross will cover 90% of UCR (Usual and Customary Rates) and the employee is responsible for 10% UCR when visiting a network provider.

PERS Choice: Once the deductible is met, Anthem Blue Cross will cover 80% of UCR (Usual and Customary Rates) and the employee is responsible for 20% UCR when visiting a network provider.

PERS Select: Once the deductible is met, Anthem Blue Cross will cover 70%-80% of UCR (Usual and Customary Rates) and the employee is responsible for 20%-30% UCR when visiting a network provider.

NOTE: This plan provides a much smaller network of doctors and all hospitals must be in the Tier 1 network of the PERS Select plan for reimbursement rate of 80/20%, the annual out-of-pocket maximum for Tier 1 hospitals is $3,000 single and $6,000 for family.  Mad River Community Hospital is the only Tier 1 hospital in Humboldt County; all other hospitals are designated Tier 2 and if services are received at these hospitals the reimbursement rate is at 70/30%.  The annual maximum out-of-pocket cost for Tier 2 hospitals increases to $6,000 single and $12,000 for family.

Peace Officers Research Association of California (PORAC)

You must belong to the Unit 8 employee association and pay applicable dues to enroll in the Peace Officers Research Association of California (PORAC). This plan is available outside of California. Refer to the plan's Evidence of Coverage for service area information.

Dental

Dental insurance is available to all benefit eligible employees. Delta Dental and DeltaCare (formerly PMI) are the only dental plans available at this time. Currently the State pays the entire premium for the employee and dependents.

Delta Dental is a widely accepted plan with many dentists to choose from.  Delta Care is much more limited. Although subject to change, there are currently no local dentists affiliated with Delta Care.

Eligibility for dental plan: Half-time or more in an appointment that exceeds six months in duration. NOTE: Part-time lecturers and coaches appointed for one semester for at least 6 WTU’s (0.4 time base) also qualify for dental coverage. Employees must enroll in a dental plan within the first 60 days of eligible employment, or serve a 90-day waiting period after enrollment before coverage begins, or wait for the next Open Enrollment period.

Seeking services before the deduction code is reflected on the payroll warrant stub may cause delays in bill payment.  If you need to seek services before the deduction code appears, please contact Human Resources 826-3626. 

Vision and Hearing Aid Discount Plan

Vision insurance is available to all benefit eligible employees. Vision Service Plan (VSP) is the only vision plan available at this time. Currently the State pays the entire premium for employees and their dependents. If eligible, enrollment will be automatic and no action is necessary. Eligibility for the vision plan is identical to the requirements for the health and dental plan information listed above. 

Seeking services before the deduction code is reflected on the payroll warrant stub may cause delays in bill payment.  If you need to seek services before the deduction code appears, please contact Human Resources 826-3626. 

The following vision benefits are available to eligible HSU employees:

  • In-network frame allowance - $95.00;
  • Out-of-network frame allowance - $60.00;
  • In-network contact lens allowance - $120.00;
  • Polycarbonate lenses are covered for dependent children in-network up to age 23; and
  • Discounts of approximately 15% for laser correction surgery are available

Through VSP, employees are also eligible to take advantage of the TruHearing Hearing Aid Discount Plan. 

Flex Cash

FLEXCASH is an optional benefit plan that allows eligible employees to waive CSU medical and/or dental insurance in exchange for cash if they have other non-CSU coverage. Employees participating in this program will receive additional taxable income each month up to a maximum of $140. This benefit is offered to all bargaining units. Employees who are covered as dependents of employees of the CSU system are not eligible to participate in the Flex Cash Plan. Employees must enroll during the first 60 days of eligible employment or wait for the next Open Enrollment period, unless a change of status event occurs as defined by the Flex Cash brochure available in Human Resources.

COBRA

As a result of federal legislation enacted in 1986, employees or family members who lose medical, dental or vision coverage through the University as a result of a qualifying event have the right to participate in a group benefits continuation plan. A group continuation plan is a health, dental, or vision insurance plan with identical coverage to the current group plans. The cost of this coverage may not exceed 102% of the applicable group premium rate. Upon termination of employment, notification of the right to continue benefits will automatically be sent to the last known home mailing address by Human Resources. It is important that employees maintain a current mailing address. Please contact Human Resources if additional information is required. 

HIPAA Information

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on the use and disclosure of individual health information by employer health plans.  Please carefully review this notice. It describes how medical information about you may be used and disclosed and how you can get access to this information.