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California State University, Long Beach
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For more information, please contact Human Resources

Phone: (562) 985-7476

All submissions are due by Monday, November 30th at 3:00pm.

Welcome to our Open Enrollment Resource Page!

Open Enrollment is your opportunity to review and make changes to your medical, dental and vision plans.

The Open Enrollment period will be held from Monday, November 9, 2015 through Monday, November 30, 2015. The deadline to submit changes to Human Resources is Monday, November 30, at 3:00 pm, and elections made during Open Enrollment will become effective January 1, 2016.

The Group Health Insurance Open Enrollment Change Notification Form is now required whether there is no change or if you plan to make any change(s) to your plan coverage for the upcoming plan year. This form notifies the 49er Shops of your plan coverage action(s) taken during Open Enrollment. Additional enrollment forms may be required.

Delta Dental PPO**

The Shops now offers Delta Dental of California as the Dental PPO plan of choice. Dental HMO remains with MetLife/Safeguard HMO. If you wish to make any changes with the Dental PPO plan option now through Delta for 2016, please inform the Human Resources department as additional paperwork is required. If you are satisfied with your health coverage and do not want to make any changes, simply complete the Open Enrollment Change Notification Form to notify our office that you do not wish to make any change to your existing plan coverages for the 2016 plan year.

**If you are a MetLife Dental PPO subscriber in 2015, you will be rolled over to Delta Dental PPO and a Delta Enrollment Form will be required for 2016. Please contact our office for additional paperwork required.

Employer Contributions

The monthly contributions have increased to the amounts listed below, and the Forty-Niner Shops will contribute these amounts toward your total monthly premiums based on the coverage group you have selected from our plan options:

  • Employee Only — $574.72/month
  • Employee + One — $1,197.41/month
  • Employee + Family — $1,713.89/month

Medical Plan Options and Rates

To review the medical plan options available, we have centralized all the open enrollment information based on your coverage eligibility classification: Current Employee, Early Retiree, and Medicare Retiree. Please select the tab that best reflects your classification to review the specific plans available to you.

Current Employee


Early Retiree


Medicare Retiree