FAQs
Want to know how the flex spending accounts work? Or what to do if traveling and need medical care out of state? Or when you’re eligible for retirement benefits? You’ve come to the right place! Find answers to these questions and more on this page.
The eligibility rules for benefits vary plan by plan. Here’s your roadmap to who’s eligible:
HEALTHCARE, INSURANCE AND FLEX SPENDING ACCOUNT ELIGIBILITY
- Benefits-eligible employees regularly scheduled to work 20 or more hours per week, or employment services agreement employees, may enroll in healthcare, insurance and Flexible Spending Account benefits. Employees eligible for the healthcare and insurance plans may enroll eligible family members under their coverage.
- Employees classified as per diem, limited benefits and “non-benefited” in the Cedars-Sinai payroll system may enroll themselves and eligible family members in the Anthem Blue Cross HMO (on a self-pay basis), but not the Wellness Matters Incentives or any other healthcare, insurance or Flex Spending Account benefits.
- Not eligible: Part-time employees (regularly scheduled to work less than 20 hours a week), visiting scientists, temporary employees, employees classified as A5, A6 or AZ in the Cedars-Sinai payroll system, employees working on a project basis or less than full-time faculty are not eligible for the Wellness Matters Incentives or any other healthcare, insurance or Flexible Spending Account benefits.
Wellness Matters Incentives ELIGIBILITY
To receive a Wellness Matters Incentives contribution, you must:
- Be a benefits-eligible employee regularly scheduled to work 20 or more hours per week or a professional services contract employee
- Be enrolled in a Cedars-Sinai sponsored medical plan (such as the Anthem Blue Cross HMO or Anthem Blue Cross PPO), and
- Complete the wellness steps described in the Annual Enrollment communications by the deadline.
EMPLOYEE WELLNESS PROGRAM ELIGIBILITY
All employees (including employees not enrolled in or not eligible for medical plan coverage and those not eligible for any other benefits) are eligible – and encouraged to! – participate in the employee wellness program, which includes exercise classes, gym membership discounts, and similar wellness activities listed on the Cedars-Sinai intranet at Home>Administrative>Employee Wellness Program.
403(B) PLAN ELIGIBILITY:
Any employee who receives a paycheck from Cedars-Sinai may participate in the 403(b) Plan.
YOUR CHOICE RETIREMENT PROGRAM ELIGIBILITY
Generally, employees are eligible for the Defined Contribution (DC Plan) or Defined Benefit (DB Plan) the quarter after 1 year (with a minimum of 1,000 paid hours). However, the following types of employees are not eligible to participate in the Your Choice Retirement Program:
- Per diem employees hired after June 30, 1989
- “Non-benefited” employees
- Physicians-in-training
- Executives and faculty members who participate in the grandfathered executive retirement plan.
No!
You have 30 days from birth to log in to cedars-sinai.mybenefitchoice.com or call the MBC HR Benefits Help Desk and enroll your child. You must enroll your newborn, even if you’re covered by the medical plan and the birth is covered by the medical plan.
If you don’t enroll your child within the 30-day window, your child will not be covered – and the plan will not pay for any well-baby visits, immunizations or other medical expenses. Your next opportunity to enroll your child will be the next Annual Enrollment (held in May for a July 1 effective date).
Yes – as long as you enroll your new spouse within 30 days of marriage.
If you miss your 30-day deadline, your next opportunity to enroll your spouse will be the next Annual Enrollment (held in May for a July 1 effective date).
There are 3 times you can enroll in or change your healthcare, insurance and Flex Spending Account benefits:
- Within 30 days of being hired or first becoming eligible for benefits, or upon rehire or reinstatement
- Each May, during Annual Enrollment for healthcare, insurance and Flex Spending Account benefits (coverage effective July 1)
- Within 30 days of having a qualified life event that changes your eligibility for benefits. (For a list of qualified life events, see “What’s a qualified life event?”)
From the Benefits Portal Home Screen under Benefits Enrollment Site, click “View Your Benefits.” You’ll need to register the first time you log in.
There are 3 times you can enroll in or change your healthcare, insurance and Flex Spending Account benefits.
- Within 30 days of being hired or first becoming eligible for benefits, or upon rehire or reinstatement
- Each May, during Annual Enrollment for healthcare, insurance and Flex Spending Account benefits (coverage effective July 1)
- Within 30 days of having a qualified life event that changes your eligibility for benefits. (For a list of qualified life events, see “What’s a qualified life event?”)
It's a situation that allows you to change some or all of your healthcare, insurance or Flex Spending Account benefits outside of the normal enrollment periods.
Generally, you cannot change benefits during the July 1 to June 30 period, unless you have a qualified life event or special enrollment rights (a situation that allows you to change some or all of benefits).
Qualified life events include:
- Childbirth, adoption or placement for adoption
- New spouse or child (in this situation, you may enroll yourself and family members if you’ve never enrolled)
- Domestic partner becoming eligible for benefits
- Family members becoming eligible
- Child losing eligibility (turning 26)
- Death of spouse/domestic partner or child
- Divorce, legal separation, annulment or end of domestic partnership*
- Involuntary loss of other healthcare coverage (for reasons other than failure to pay the premiums)
- Gaining healthcare coverage under another employer’s plan (including enrolling in your spouse’s/domestic partner’s employer’s plan during their annual/open enrollment)
- Medicare enrollment
- Significant increase in healthcare premiums or decrease in benefits
- Changes in employment status that affect eligibility status
- Change in residence so that you are no longer in the HMO provider area (California)
- Judgment, decree or order requiring coverage for dependent(s) (including Qualified Medical Child Support Orders).
*You cannot cover your ex-spouse under Cedars-Sinai plans. If your divorce decree requires you to cover your ex-spouse, you’ll have to purchase a policy for your ex-spouse elsewhere, such as the state healthcare exchange. COBRA will be offered if your ex-spouse had coverage under your benefits and Cedars-Sinai is notified within 60 days of the divorce.
It depends on the type of life event you have, because the benefits change has to be directly related to your life event.
There are several ways you can find out:
- See the Healthcare, Insurance and Flex Spending Account Benefits Summary Plan Description (Enrolling in or Changing Benefits)
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From the Benefits Portal home page, log in to the Benefits Enrollment Site, and:
- Click the “Make Changes” button
- Select “Create Life Event”
- And then select the life event that matches your situation
You’ll be allowed to change only the benefits that apply to your situation.
Within 30 days of the life event you may:
-
Make the change online at Cedars-Sinai.MyBenefitChocie.com.
- From the Benefits Portal home page, log in to the Benefits Enrollment Site, and:
- Click the “Make Changes” button
- Select “Create Life Event”
- Select the life event that matches your situation (You’ll be permitted to change only the benefits that apply to your situation)
- You will be asked to upload documentation supporting the change (for example a birth certificate, divorce decree or marriage certificate).
- Contact the MBC HR Benefits Help Desk (at 888-302-3941 or email MBC.cshs@milliman.com) to report the change and have them enter the change into the enrollment system for you.
You have 45 days from the date your benefits start to upload or send the documentation to the MBC help desk. If you miss the deadline, the benefit change will not become effective and you will have to wait until the next Annual Enrollment to change your benefits or enroll new family members.
IRS rules do not allow us to accept changes more than 30 days after the life event. If you miss the 30-day deadline, we cannot make the change. Your child will not be covered and our plan will not pay for any well-baby visits, immunizations or other medical expenses.
Your next opportunity to enroll your child or make the election changes will be during Annual Enrollment in May for coverage starting the next July 1.
To avoid a lapse in coverage in the interim, you might be able to enroll your child in a marketplace health plan; these plans allow changes up to 60 days after a qualified life event. Visit CoveredCA.gov (or Healthcare.gov) for more information.
403(b) Plan - You can enroll to make tax deferred contributions to a savings and investment account any time. After 1 year (with a minimum of 1,000 paid hours) when you contribute, Cedars Sinai makes matching contributions equal to 50% of what you contribute, up to a maximum match of 3% of pay.
DC + DB Plan - The quarter after 1 year (with a minimum 1,000 paid hours) you will have an opportunity to select which of these Cedars-Sinai retirement plans you want to participate in. Both plans are paid 100% by Cedars-Sinai. Once you meet the eligibility requirements, Cedars-Sinai will mail you a choice packet with information to help you choose. (Make sure your address is up to date to ensure you receive this packet.)
To enroll in the 403(b) Plan, contact the plan record keeper, Voya Financial:
Enroll online: Cedars-Sinai.BeReady2Retire.com
By phone: 800-584-6001
Voya Financial representatives can meet with you and help with investment education and retirement planning. For an appointment, call the Voya Financial CSMC office at 310-423-0974.
When you enroll, remember to designate beneficiaries for your 403(b) Plan account.
The DB Plan or DC Plan – The quarter after having 1 year (with a minimum of 1,000 paid hours) at Cedars-Sinai, benefit-eligible employees will receive a choice packet with information to help choose which plan they want. (Make sure your address is up to date to ensure you receive this packet.)
If you are eligible for benefits and you enroll, you may cover your spouse or domestic partner and children, as defined below.
Spouse - Your opposite or same-sex spouse.
Domestic Partner - With whom you are legally registered as domestic partners, or have complete Cedars-Sinai’s domestic partner affidavit and meet all of the following criteria:
- Have been sharing a common residence* for at least 6 months and intend to do so indefinitely
- Are not related by blood to a degree of closeness that would prohibit marriage
- Have assumed mutual responsibility for basic living expenses
- Are at least age 18 and capable of consenting to the domestic partnership
- Are not married to anyone else or in a declared domestic partnership with anyone else.
*Although you don’t have to show proof of common residence or evidence of joint responsibility for basic financial obligations to enroll, Anthem Blue Cross or Unum may require it before paying claims.
Children – Your or your current spouse’s/domestic partner’s biological children, stepchildren, adopted children, children placed with you for adoption, children for whom you are the legal guardian and children a court has ordered you to cover under your healthcare plan, who are under age 26.
Children age 26 and older can be covered if, in addition to meeting the requirements above, all of the following apply:
- A doctor certifies in writing that they are incapable of getting a self-supporting job because of a physical or mental condition (and the certification is approved by the insurance company), and
- They are unmarried and chiefly dependent on you, your spouse or domestic partner for support and maintenance, and
- They have 6 months of creditable coverage or were already covered under Cedars-Sinai benefits on their 26th birthday.
You must submit the doctor’s certification to the insurer/benefit provider within 30 days of request (or a later deadline, if provided by the insurance company). To continue coverage, you may have to provide the doctor’s certification once a year.
Log in to the MyBenefitChoice enrollment site
Click the “Make Changes” button
Select “Create Life Event”
Select “Domestic Partner – New”
To enroll your domestic partner, you will need to provide either your state issued domestic partnership registration or complete the Cedars-Sinai Domestic Partner Affidavit
You can apply to MetLife online at metlife.com/mybenefits or by calling 800-438-6388.
You can enroll any time, but to receive the Cedars-Sinai discount and pay the premiums through payroll deduction, you must wait 30 days after becoming eligible for benefits to enroll with MetLife).
Keep in mind this is individual, not group insurance. MetLife determines if you qualify for coverage.
You can apply directly with Nationwide anytime (no set application period) by phone at 877-738-7874 or online at petinsurance.com/cedars-sinai. Dogs and cats age 10 and over are not eligible for coverage.
You have 30 days to enroll in healthcare, insurance and FSA benefits:
- 30 days from your date of hire (or becoming eligible for benefits)
- 30 days from any qualified life event that permits you to enroll or change benefits.
(You may only enroll during Annual Enrollment or the 30 day period following a life event or hire/becoming eligible for benefits.)
- If you enroll or change benefits during Annual Enrollment, your benefits start July 1
- If you enroll because you are a new employee or transferred to a benefits-eligible position, coverage usually starts on the first day of the month after your date of hire or transfer. For example, if Anna is hired on Aug. 15 and enrolls on Aug. 29, her coverage starts on Sept. 1.
- If you enroll or make benefit changes due to a qualified life event, or changing to a benefit-eligible position, your new benefits start the first day of the month after the life event.
Exceptions:
Exception for birth, adoption or placement of a child for adoption in your home – If you enroll your new child (and yourself and eligible family members if not already covered) within 30 days of birth/placement, medical, dental and voluntary vision coverage will be retroactive to the birth or placement date; if you enroll in other benefits, coverage starts the first day of the next month.
Exception for life and disability insurance:
- Insurers require employees to be actively at work (and family members must not be disabled or hospitalized) for life or disability insurance to start. If you’re not actively at work when coverage is scheduled to start, your life insurance, AD&D and LTD insurance coverage may be delayed until you return to work. See the insurance company booklets for more information.
- If you apply for voluntary life insurance for yourself or your spouse/domestic partner, amounts requiring insurer approval start the first day of the month after receiving insurer approval (or July 1, if later, for Annual Enrollment changes).
- During your first 12 months of coverage, LTD (and voluntary LTD) does not cover conditions you’ve had for 3 months before your coverage started, but it will cover new conditions. See the summary plan description for more information.
Coordination of Benefits – People often mistakenly think that with dual coverage, the secondary plan will pay everything the primary plan does not cover – but that’s not how it works.
If covered by both your employer’s and another medical plan (such as your spouse’s plan), usually the plans coordinate payment so the benefits from the plans together equal the total benefits from the plan with the higher benefits.
The plan that covers you as an employee will be primary and the other plan pays benefits only if it covers a higher benefit. For example, if the employer plan covers 80% and the other plan covers 90% of the allowed amount, the employer’s plan pays 80% and the other plan pays 10%. If both plans cover 80%, the other plan pays 0%. Neither plan pays more than the allowed amount. (The allowed amount is the maximum the insurance company pays for a healthcare service.)
Rules are different for Medicare or in some situations. See the Anthem booklet for details.
Yes. You are covered for emergency care when you are out-of-state.
If you or a family member will be living outside of California for 90 days or longer, you may be able to get a guest membership in the Blue Cross Blue Shield plan in your temporary home area. This program is ideal for out-of-state college students or a spouse on an extended out-of-state work assignment.
The guest membership program offers comprehensive care at the best price available. The attached flyer describes the guest membership program. Before you leave home, call Anthem at 800-227-3641 and ask for the guest membership coordinator.
Yes, if you enroll in an HMO, you must have a primary care physician (PCP). If you did not select a PCP during Annual Enrollment, you and your family members were randomly asigned one from Cedars-Sinal Medical Group or Cedars-Sinal Health Associates.
Yes, you can change PCPs at any time, as long as you aren’t getting a course of treatment from your current PCP or a specialist within the same group practice.
If you are enrolled in the Blue Cross HMO, to change PCPs you must contact Anthem at 800-227-3641 or make the change online at Anthem.com/CA.
If you are enrolled in the Vivity Premier HMO, to change PCPs you must contact Vivity at 844-659-6878 or make the change online at Anthem.com/CA.
If you make the change by the 15th of the month, the change usually takes effect the first day of the next month. If you change your PCP after the 15th of the month, the change will take affect the 1st of the month after the next.
Under the life and AD&D insurance plans, you can designate anyone as your beneficiary(ies).
Under the retirement plans, if you are married, your spouse has a legally-protected right to be your retirement plan beneficiary. You can name someone else as your beneficiary(ies), but your spouse will have to consent by signing the waiver on the beneficiary form, with the signature witnessed by a notary.
If you are married and want to name someone other than your spouse as beneficiary with your spouse’s consent, call Voya Financial at
800-584-6001 (403(b) Plan and DC Plan) and/or the DB Plan Pension Center at 866-296-5034 to request the forms. Then complete the forms, have your spouse sign the waiver in front of a notary (who will add the seal and sign), and return the forms to Voya Financial or the DB Plan Pension Center.
Yes. You’ll need to provide a mailing address (which is true for all beneficiaries, regardless of where they live).
You must designate a beneficiary for each life insurance and AD&D plan you have:
Log in to the MyBenefitChoice enrollment site
Select “Make a Change”
Select “Create or Update Beneficiaries”
You must designate a beneficiary for each retirement plan you participate in
-
403(b) Plan and/or DC Plan
Online: Cedars-Sinai.BeReady2Retire.com
or call 800-584-6001 to request a beneficiary designation form. -
DB Plan
Online: Cedars-Sinai-MyRetirement.com
or call 866-296-5034 to request a beneficiary designation form.
Has your address or phone number
changed?
Be sure to let us know!
The quickest way is on the Cedars-Sinai intranet:
> Human Resources (top of page)
> Change My Personal Information
> Download the Employee Address and Phone Change form (ePAF) (download button near the bottom of the page)
If you have access to your Cedars-Sinai email:
> Complete the online ePAF and click “Electronic Submit” (using your Cedars-Sinai email account)
● Note: the ePAF (online PDF) requires Adobe Acrobat; if using Internet Explorer, Acrobat is the default when you open the ePAF from the website.
If you don’t have access to your Cedars-Sinai email:
> Print and complete the form, and fax it to HR Employee records: 310-423-0365.
If you need help, contact the HR Service Center:
● Call: 424-314-myHR (6947)
● Email: myHR@cshs.org
The Wellness Matters Incentives is a Cedars-Sinai funded account that you can use to pay for eligible out-of-pocket healthcare costs, such as:
- Deductibles and co-insurance
- Prescription drugs
- Hearing aids
- Vision exams
- Co-payments
- Dental and orthodontia
- Acupuncture
- Physical therapy
- Glasses and contact lenses
- Laser eye surgery
- Chiropractic care
- Speech therapy
- Public transportation to and from a healthcare facility to receive healthcare services.
To get the contribution, you must be enrolled in either a Cedars-Sinai sponsored medical plan (Blue Cross HMO, Blue Cross PPO or Vivity Premier) for the upcoming July 1 to June 30 benefit period and complete the healthy actions by the deadline.
If enrolled in a Cedars-Sinai medical plan, you can earn Wellness Matters Incentives contributions by taking healthy actions, including Partnering with Your PCP and completing Biometrics.
Submit a Proof of Healthy Action form and your receipt or other documentation to TRI-AD via the tri-ad.com portal.
Yes. Both are terrific programs to help you pay less for out of pocket healthcare expenses.
Keep in mind that both accounts use the same healthcare payment card, and the funds will be taken from your Healthcare Flexible Spending Account first. Once your Healthcare Flexible Spending Account balance is depleted, funds will be withdrawn from your Wellness Matters Incentives.
A healthcare payment card works like a debit card. When you have qualified eligible expenses at a physician’s office, hospital, clinic or pharmacy that accepts healthcare payment cards, simply swipe your card. The amount of your qualified purchases will be deducted – automatically – from your account, and electronically transferred to the provider/merchant for immediate payment. When swiping your card, you can select “Credit,” or select “Debit” and use your PIN.
Your Wellness Matters Incentives and your healthcare FSA contributions are deposited to accounts with TRI-AD, our Wellness Matters Incentives administrator. Go to tri-ad.com to manage your account, submit claims for reimbursement, etc.
If covered by the Blue Cross HMO or PPO
Retail
You’ll get the best value if you have your prescription filled at a MedImpact participating pharmacy. To find a participating pharmacy:
MedImpact Pharmacy locatorMedImpact Customer Service at 800-788-2929.
Mail Order
You can obtain a 90-day supply of medication through a mail order program with Walgreens. The medication will be delivered right to your home.
To get started, you can register online or call Walgreens to obtain a mail order form. (Forms are also linked below.)
(When ordering online, be sure to choose the Tempe, AZ facility.)
866-304-2846 (English)
800-573-1833 (TTY English)
800-778-5427 (En español)
877-220-6173 (TTY en español)
If covered by the Vivity Premier HMO
Retail
- Express Scripts’ large network includes Rite Aid, Ralphs, Walgreens, Target, CVS and Vons
- To find a participating pharmacy, visit Anthem.com/CA or call 800-227-3641
Home Delivery Program
Order online at Anthem.com/CA or call the Customer Service number on your member ID card