FlexElect Program for the next Plan Year and do not wish to make any changes to their medical and/or dental insurance they will not be required to complete a HBD- and/or STD. to continue their traditional medical and dental insurance at their current level of benefits.
Employees who were enrolled in the Cash Option and do not want to be automatically reenrolled will need to cancel their enrollment. In addition, in order to obtain State-sponsored benefits they MUST reenroll in a medical and/or dental insurance plan.
Reenrollment into traditional health and/or dental is NOT automatic for Cash Option participants who elect to cancel their db to data enrollment. Completion of the HBD-/STD. forms are required. In this instance, they should follow the instructions on page.
If employees do not wish to reenroll in the FlexElect Program for the next plan year and wish to make changes to their medical and/or dental insurance, they MUST complete a HBD- and/or STD. reflecting the changes. The HBD- should be sent to CalPERS for processing and the STD. should be sent to the SCO for processing.
The HBD- and/or STD. must be completed during the FlexElect Open Enrollment Period. Use the following information when completing these forms:
Effective Date: January (of the following year)
Permitting Event Date: Beginning of open enrollment date (of the current year)
Reason Code: (HBD-)
Permitting Event Code: (STD. )
Remarks: Enter Employee cancelling FlexElect and reenrolling in traditional State-sponsored medical (or dental) insurance.
For dental insurance, remember that the choice employees made for dental insurance is a three-year commitment. Accordingly, if employees opted out of dental and received cash, they cannot reenroll in a State-sponsored dental plan, for three years, unless they lose their other
coverage (under spouse, domestic partner, or other coverage). Please see Section , Plan Options, for more information regarding the three-year commitment.
Forms Distribution
The FlexElect Handbook contains one copy of both the Cash Option Enrollment Authorization (STD. C) and the Reimbursement Account Enrollment Authorization (STD. R). If employees enroll by using one of these forms, two additional copies of the form must be photocopied. Return one copy to the employee for his/her personal records; retain one copy in the Personnel Office. Be sure to attach all other appropriate forms (i.e. HBD- Health Benefit and Enrollment History page after confirmation from my|CalPERS, STD. ) to the original.
