This job aid shows Benefits Officers how to print enrollment forms on demand for individuals from two locations. The State Controller’s Office requires these forms to process benefits eligibility.

• Print forms from Health Benefits
  • HBD-12, SCO Form 692, SCO Flex Cash Medical and Dental Forms
• Print FSA enrollment forms from Spending Accounts
• Print enrollment forms from On-Demand Event Maintenance

• Do not print enrollment forms until CSUBASDL has finalized employee self-service (ESS) BAS Events or non-ESS BAS events have been manually finalized.

Use this procedure to find and print medical and dental and flex cash forms for an employee.

Step 1: Open the CSU Benefits Administrator tile.

Step 2: Navigate to Health Benefits.

• Review Employee Benefits > Health Benefits

Step 3: Enter search criteria for the employee.

• Name: Enter first name [space] last name.

Step 4: Click Search.

• If only one employee is returned, the Health Benefits page opens. Otherwise, select an employee to continue.

Step 5: In the Plan Type section, select the row with the plan type to print.

• Valid Plan types include 10, 11, 1Y and 1Z.
• In this example, row 1 is for medical forms.

Step 6: In the Coverage section, select the effective dated row for the coverage interval.

• In this example, only one row exists, so the control is inactive.

Step 7: Open the CSU Hlth Perm Evnt tab.

Step 8: In the Permitting Event section, select the row with the applicable Permitting Event Code.

Step 9: Click Print.

• The form prints in PDF format on a new browser tab

Step 1: Open the CSU Benefits Administrator tile.

Step 2: Navigate to Spending Accounts.

• Review Employee Benefits > Spending Accounts

Step 3: Enter search criteria for the employee.

Step 4: Click Search.

• If only one employee is returned, the Health Benefits page opens. Otherwise, select an employee to continue.

Step 5: In the Plan Type section, select the row with the plan type to print.

Step 6: In the Coverage section, select the effective dated row for the coverage interval.

• In this example, only one row exists, so the control is inactive.

Step 7: Open the CSU FSA Perm Evnts tab.

Step 8: In the Permitting Event section, select the row with the applicable Permitting Event Code.

• In this example, only one row exists, so the control is inactive.

Step 9: Click Print.

• The form prints in PDF format on a new browser tab.

Step 10: Verify

• Compare the monthly contribution amount on the form to the monthly contribution amount located on the spending accounts page for each plan type.
• If amounts are incorrect or blank
  • Use correction mode
  • Enter the monthly contribution amount.

Use this procedure when you select enrollment options for an employee and then need to print the forms immediately.

Step 1: Open the CSU Benefits Administrator tile.

Step 2: Navigate to On-Demand Event Maintenance.

• Enroll in Benefits > On-Demand Event Maintenance

Step 3: Enter search criteria for the employee.

Step 4: Click Search.

• If only one employee is returned, the On-Demand Event Maintenance page opens. Otherwise, select an employee to continue.

Step 5: Process the employee’s benefits enrollment for the applicable BAS event.

• The reason to print the form from On-Demand Event Maintenance is that you have just entered enrollment options for an employee and then need to print the enrollment forms.
  • Select the BAS event.
  • Select enrollment options for the employe.
  • Finalize the event.
  • For more information about this step, review Finalize BAS events with ODEM.

Step 6: Open the CSU On Demand Printing tab.

Step 7: Click Print.

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