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HEALTH INSURANCE PLANS
As an employee at CSU, Bakersfield, you have the opportunity to participate in a variety of benefit programs. These voluntary programs include health, dental, vision, life, disability, long term care, personal insurance, tax sheltered annuities, fee waivers for CSUB classes and many others. You will also participate in one of two retirement plans. If you have specific questions regarding your benefits, please contact the Office of Human Resources at extension 2266 for assistance.
Medical Insurance Plans
The University offers a variety of medical insurance plans available to covered employees and their eligible dependents, with the majority of the premiums paid by the CSU. Medical Insurance coverage for eligible CSU employees is administered by the Public Employee's Retirement System (CalPERS). Employee rates vary depending on the plan selected, coverage level and employee category.
When you choose a health plan, be sure to review the plan's covered and non-covered services and the restrictions on your choice of providers. The combination of health plan and providers that is right for you depends on a variety of factors, such as whether you prefer a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO); your premium and out-of-pocket costs; and whether you want to have access to specific doctors and hospitals. There are two types of plans from which to choose:
Health Maintenance Organizations (HMO)
An HMO is a plan that provides healthcare from specific doctors and hospitals under contract with the plan. While you pay co-payments for some services, you have no deductibles, no claim forms, and a geographically restricted service area. The HMO will give you a list of doctors for your use in choosing a primary care physician (PCP). The PCP coordinates all your care, including referrals to a specialist. If you go outside of the HMO without a referral from the plan, you'll be responsible for the total cost of services, except for emergencies or urgent care services. The following links provides you with a summary and comparison of each plan's benefits and copays.
Preferred Provider Organizations (PPO)
A PPO is similar to a traditional "fee-for-service" plan, but you must use doctors in the PPO provider network or pay higher co-insurance (percentage of charges). A PPO allows you to select a primary care provider and specialists without referral. In these plans, you must usually meet an annual deductible before some benefits apply. You are responsible for a certain co-insurance amount and the plan pays the balance up to the allowable amount. Similar to HMO’s, the PPO Indemnity plan contracts with specific doctors and hospitals in certain areas. The plan pays higher benefits when utilizing a participating provider than a non-
participating provider. Under a PPO/Indemnity plan, there is no geographic restriction. As a PPO health plan member, you get maximum benefit coverage when you use the PPO network of physicians and hospitals.