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California State University, Long Beach
New CSULB Employees
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Health Benefits Enrollment

As a CSULB employee, you and your dependents may be eligible for an array of benefits including medical, dental, vision, life and long term disability (LTD).  If you are eligible, you will be automatically enrolled in vision, life and LTD effective on the first of the month following your hire date.  You must enroll in medical and dental benefits by submitting a Benefits Enrollment Worksheet to Benefits Services within 60 days from your date of hire. Benefits will begin the first of the month following your timely submission of the Worksheet. If you miss the 60 day deadline, you may request late enrollment, which is subject to a 90-day wait from the time the late enrollment is requested.  You also may enroll during the annual benefits open enrollment period, held during the start of the fall semester.

Eligibility

  • Staff: To qualify for health benefits you must initially have an appointment that equals or exceeds six continuous months and one day, at a time base of .5 (20 hours or more per work week) or more.  However, to continue benefits you only need to maintain an appointment of at least one-half.
  • Faculty: To qualify for health benefits you must initially have an Academic Year appointment at a time base of .5 (7.5 weighted teaching units) or greater.
  • Lecturers: To qualify for health benefits you must have a semester appointment at a time base of .40 (6 weighted teaching units) or greater.

For more information on benefits and eligibility including available health plans, please visit our Benefits Services site.

Documents

The following documents are needed to enroll in health benefits:

Enrolling Employee Only

Enrolling Employee and Dependents

  • 60-Day Notice Form signed by employee
  • Benefits Enrollment Worksheet completed and signed by employee
  • Affidavit for Married Persons form (if enrolling spouse) and spouse's Social Security Number
  • Copy of Marriage Certificate (if enrolling same or opposite sex spouse) and spouse's Social Security Number
  • Copy of a Declaration of Domestic Partnership (if enrolling domestic partner) and domestic partner's Social Security Number
  • Copy of Birth Certificate (if enrolling dependent children under age 26) and children's Social Security number

All documents must be returned to Benefits Services (Brotman Hall 353)