CSU Benefits Plan (Cost Share)

This plan is for newly appointed or newly benefits-eligible non-classified staff as of January 1, 2008, or after or staff previously enrolled in Ben Pay who elected the Cost Share plan during annual enrollment.

Summary Plan Booklet (Cost Share)
This booklet contains medical, dental, life insurance, and retirement plan information.

Provider Quick Reference Sheet

Benefits Enrollment Change Forms

• Cost Share Change Form
• Life Insurance Application
• New Benefits Discount
• Savings Bond Enrollment Form

Claim Forms

• Anthem Mail Order Prescription Form
• Anthem Medical Claims
• Anthem Prescription Claims
• EBMS Dental Claim Form
• Dependent Care Flexible Spending Account
• Health Care Flexible Spending Account

Anthem Ancilliary Benefits

• Anthem Rewards
• Healthy Solutions
• Special Offers
• 24-Hour Nurse Line

Certificates of Insurance

• Anthem Gold Plan
• Anthem Green Plan
• Anthem POS Plan

Medicare Part D Notice