PLEASE NOTE: The links on this page open in a new window & the majority are PDFs.
Eligibility Information
To be eligible to enroll in your employer’s benefit plans, you must be a full time W-2 employee working 30 or more hours a week for the company and satisfy the new hire probation period.
Please refer to the Probation Calendar below and contact the person responsible at your employer for your company benefits. Also refer to the enrollment guidelines in the next section.
FOMA 60D Probation Calendar for those hired May 1st 2015 and later
Benefit Resource Center Flyer for Employees
Enrollment Guidelines
Please read the Enrollment Guidelines to learn when you can come on the plan, add dependents and make other changes.
Health Plan Enrollment Guidelines
Premium Charts
Request for Custom Premium Worksheet
Opt 1 Please complete the above form and email to us.
Opt 2 Employers can register at www.calchoice.com and access custom worksheets 24×7
COBRA Center
Our records show your group is subject to Fed COBRA
The Initial Notice should be provided to the employee AND spouse (if covered) within 90 days of becoming covered. One notice to the home is allowed if both live at the same address but it must be addressed to both parties.
Please contact your employer for more information.
COBRA QE Letter for Qualifying Events
Cal Choice Fed-COBRA Enrollment Form
Choice Builder Fed-COBRA Enrollment Form
Help & Support
PLAN DEPARTMENTS | PHONE/MEMBER SERVICES | PLAN/POLICY # |
---|---|---|
Cal Choice Main Member Services # | 1-800-558-8003 | 42160 |
Anthem Member Services | 1-866-524-5659 | |
Health Net Member Services | 1-866-524-5659 | |
Health Net Member Services | 1-800-464-4000 | |
Choice Builder Customer Service Center | 1-866-412-9279 | B04021 |
Delta USA DHMO Automated System | 1-800-422-4234 | SSN |
Ameritas Dental | 1-800-487-5553 | |
Wayco Insurance Services, Inc. (Broker) | 1-951-699-6000 x10 | john@wayco.com |
Cafeteria Plan
Your Cafeteria “Section 125” Pre-Tax Premium plan allows payroll deductions to be taken “off the top line” before taxes are calculated ~ saving from 25% to 40% depending on your personal tax bracket.
Example of Cafeteria Plan Savings
Medical Plan
BENEFIT SUMMARIES | FORMS LIBRARY | WEB SITE LINKS |
---|---|---|
Cal Choice Health Plan Highlights 5-2025
Choose from Silver & Gold Levels |
New Member Enrollment Form | Cal Choice Website |
Cal Choice Provider Search Tool Flyer | Existing Member Change Form | Cal Choice Provider Search Tools |
Smart Phone Apps Flyer | Enrollment Steps | |
Web Link for downloading Summary of Benefits | ||
New Hire Quote Request Form | Anthem Website | |
Domestic Partner Form | Health Net Website | |
Termination Report (Employer Use) | Kaiser Website |
Dental & Life Plan
BENEFIT SUMMARIES | FORMS LIBRARY | WEB SITE LINKS |
---|---|---|
Choice Builder Dental Summary & Premiums (Based on 26 pay periods/after employer benefit allowance.) Employer provides $10,000 of Group Life. (Use the same enrollment form as dental.) |
Dental & Life Enrollment Form | Provider Search Tools / Choice Builder Web Link |
Effective 5-1-2023 to 4-30-25 | Dental & Life Change Form | Dental Provider Search Tips |
Termination Form (Employer Use) |