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California Public Employees' Retirement System P.O. Box 942714 Sacramento, CA 94229-2714 HEALTH BENEFIT PLAN ENROLLMENT FORM DO NOT SEND MEDICAL CLAIMS TO THIS ADDRESS PERS-HBD-12 (Rev.8/10) PLEASE.

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Related content

Health Benefits Enrollment Form HBD-12 - CalPERS...
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for Active Employees (HBD-12) www.calpers.ca.gov. 3. 5. 6. ... Please retain original...
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To become eligible, you must receive credit for a minimum of 480 paid hours at the end of a control period. To continue your eligibility, you must either: Be credited with at least 480 paid hours at the end of each control period. Have at least 960 hours in two consecutive control periods (current and prior)

To become eligible, you must receive credit for a minimum of 480 paid hours at the end of a control period. To continue your eligibility, you must either: Be credited with at least 480 paid hours at the end of each control period. Have at least 960 hours in two consecutive control periods (current and prior)

Permanent-intermittent employees are eligible for health benefits after being credited with a minimum of 480 paid hours at the end of a six-month control period. The State pays a portion of your premium, referred to as the employer contribution.

Once you retire, CalPERS becomes your health benefits officer. You can change your health plan and add/delete dependents during Open Enrollment in the fall (or within 60 days of a qualifying status change). Your health premiums are deducted from your retirement pay.

Permanent-intermittent employees are eligible for health benefits after being credited with a minimum of 480 paid hours at the end of a six-month control period. The State pays a portion of your premium, referred to as the employer contribution.

Health insurance in California While health insurance isn't required by state law, federal law requires employers with 50 or more full-time equivalent employees (FTEs) to provide insurance with minimum essential coverage (MEC). Offering health benefits to your employees is a great way to attract and retain top talent.

Eligibility Requirements: Conditions that must be met in order for an individual or group to be considered eligible for insurance coverage.

1 The eligibility ZIP code is used to determine the health plans in which you are eligible to enroll. If you are an active employee, you may choose either your residential or current work address ZIP code to establish eligibility.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232