Current Employee Plans
To Make Changes
If you are interested in enrolling into a new plan or adding/removing dependents, please select the appropriate enrollments in the Self-Service Portal, and complete the enrollment forms for the providers you choose (available in the links below). All Self-Service Enrollments must be completed online by Friday, October 21, 2022. All additional required enrollment forms and documentation must be turned in to Human Resources by Friday, October 21, 2022 before 4:00PM. Enrollment forms and documents can be turned in physically to the Human Resources Office, or virtually to FortyNinerShopsHR@csulb.edu.
Self-Service Enrollment
Employees must make change requests through the Self-Service Enrollment Portal online at https://benxcel.net/. Please view the Self-Service Open Enrollment Instructions for additional guidance on how to login and request changes. Please note that additional forms and documentation will be required after making a change request in the Self-Service Enrollment Portal.
To Keep Existing Coverage
If you decide that you do not want to make any changes, your 2022 coverage will roll over to 2023, at the new plan rates. Please note voluntary Flexible Spending Accounts and voluntary The Hartford plans require re-enrollment each year.
Open enrollment is your opportunity to review and make changes to your medical, dental, and vision plans. During Open Enrollment you can add, delete, or change plans, or add/remove dependents from your coverage. To help navigate through Open Enrollment, we have included several frequently asked questions for your review.
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Document
- BenXcel Self-Service Enrollment Login (Web)
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Document
The Shops offer Kaiser HMO, Anthem HMO & HMO Select and Anthem PPO.
Your plan options are:
Kaiser
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Document
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Kaiser Enrollment Form (PDF, non-fillable)
Anthem HMO Select
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Document
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Anthem Enrollment Form (PDF, non-fillable)
Anthem HMO Premier - CA Care
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Document
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Anthem Enrollment Form (PDF, non-fillable)
Anthem PPO
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Document
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Anthem Enrollment Form (PDF, non-fillable)
The Shops will continue to offer the same dental plan benefits as we did last year. Our plan of choice is Delta Dental.
Delta Dental HMO
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Document
Delta Dental PPO
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Document
Delta Dental Resources
- Find a Dentist (PDF)
- Delta Dental Enrollment Form (PDF)
The Shops will continue to offer the same vision plan benefits as we did last year. Our plan of choice is VSP.
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Document
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Document
Hartford Life and AD&D Insurance
The Shops offers employer-sponsored life and disability insurance to full time employees. Below are plan summaries and services available for you.
- Hartford Short Term Disability (PDF)
- Hartford Additional Services (PDF)
- Hartford Ability Assist (PDF)
Voluntary Life and Accident Death & Dismemberment Plan
This year we will continue to offer a Voluntary Life and Accidental Death and Dismemberment Plan (AD&D). This plan will allow you to purchase additional life and/or AD&D coverage for you and your family. These voluntary plans are offered through The Hartford and provide peace of mind that your family will be provided for should something unexpected happen.
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Hartford Voluntary Plan Enrollment Form (PDF, non-fillable)
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Hartford Premium Worksheet (PDF, non-fillable)
Hartford Beneficiary Form
To update the beneficiary designation for your plan please complete the following form and return to Human Resources at any time:
Flexible Spending Account Option
The Flexible Spending Account is a voluntary plan where you elect to have automatic deductions taken from your check and put into a Flex Plan so that you do not pay taxes on that amount. The money that you elect to deduct can either be used to reimburse you for medical expenses and/or for childcare expenses that you incur during the plan year, depending on the deduction amounts for each plan in which you enroll.
The maximum annual contribution limit for Medical Flexible Spending Accounts is $2,850 and for Dependent Care is $5,000.
Benefits Waiver Program
The Forty-Niner Shops offers a Benefits Waiver Program to help manage your benefits coverage. If you have medical, dental, and vision coverage outside of the Shops, the Benefits Waiver Program pays you cash in lieu of medical coverage. You must provide proof of coverage to participate. To learn more about this program, please see the Benefits Waiver Programs summary below.
