Newly eligible employees
If you are a newly eligible excluded employee, you have 60 days to enroll once your appointment is keyed by your personnel office into the State Controller's Office system, or you can enroll during the open enrollment period that is conducted every 18 to 24 months. You may access the online Enrollment and Change Form. Please complete the form online, then print, sign and return it to your department's Personnel Office for processing. You may want to keep a copy for your files.
2010 Open Enrollment Period (April 1 - April 30, 2010)
Employees not currently enrolled in the Voluntary LTD plan will have an enrollment packet mailed directly to their home address on file. You may complete the Enrollment and Change Form that came with your packet, or you may use the online Enrollment and Change Form. Please complete the form online, then print, sign and return it to your department's Personnel Office no later than April 30, 2010 for processing. You may want to keep a copy for your files.
If you are currently enrolled in the Voluntary LTD plan and would like to make a change to your coverage during the open enrollment period, you may access the online Enrollment and Change Form. Please complete the form online, then print sign and return it to your department's Personnel Office no later than April 30, 2010 for processing. You may want to keep a copy for your files.
If an additional Enrollment and Change Form is needed, you may print one from this link, or request a copy by sending an email to .
Subject to the Active Work Requirement, LTD insurance will become effective as follows:
Premiums for the Voluntary LTD coverage will be deducted from your paycheck on an after-tax basis.
No, evidence of insurability is not required.
An enrolled member may terminate coverage at any time. Increases and decreases of coverage may only be done during a designated open enrollment period.
No, dependent spouse and children are not eligible for Long Term Disability insurance.
Please visit the State of California, Department of Personnel Administration website or call the State of California, Customer Service line at 888.641.7193.