OE Guide: City and County and Superior Court of SF Employees

Welcome City and County of San Francisco, and Superior Court of San Francisco employees to your Open Enrollment (OE) election period. The San Francisco Health Service System (SFHSS) administers your Medical, Vision, Dental, Flexible Spending Accounts (FSA), and Voluntary Benefits.

OE typically takes place each October, giving you the opportunity to select your health benefit elections for the following year. 

During this period, you may:

• Review your current medical, dental, vision, and other benefit elections.
• Compare plan options using the Benefits Comparison Tool 
• Make changes to your coverage using SF My Hub.
• Update your beneficiaries.
• Enroll in or waive coverage. 

We have scheduled Benefits Fairs where you can meet with health plan representatives and have your questions answered in person.

Find the value in your benefits by exploring programs beyond routine medical care. Depending on your health plan, you may have access to fitness programs, preventive screening, therapy, free virtual care, mental health visits, wellness coaching, prescription savings, and other services designed to support your health throughout the year.

Don't miss the opportunity to take advantage of Employee-Paid Voluntary Benefits. These exciting offerings give you more choices to enhance your overall benefits package.

***PLACEHOLDER/DRAFT:

•    MetLife will replace ID Shield 
•    Aura Protection Select (Basic) and the Aura Protection Plus is the enhanced Plan. Payroll deductions for ID Shield will stop at the beginning of the year 
•    ID Shield current members will be defaulted to Aura basic plan  "Aura Protection Select" 
•    $7.95 individually /$13.95 family 

We're excited to introduce our new Benefits Comparison Tool! Easily compare benefit plans side by side to find the best value options for you and your dependents.

Use this comprehensive Benefits Comparison Tool to compare benefit plans and make informed enrollment decisions. This tool is for comparison only and does not enroll you in a plan. To enroll, use SF MyHub.

If you are an MEA member, all or a portion of the premium amounts shown may be covered by your Flex Credits. See Flex Credits for Members of the Municipal Executives Association (MEA) in the left navigation menu for more information.


***PLACEHOLDER ADD BUTTON

If you’ve done this enrollment process before, here’s a quick way to make changes:

• Review your digital Open Enrollment Statement to see your current medical, vision, and dental elections
• Use the Benefits Comparison Tool to compare plans
• Then complete your new elections by clicking on the SF My Hub 

If you're new to this process or need a refresher, follow the steps below. Use this comprehensive guide to help you further navigate SF My Hub: SF My Hub Navigation Instructions.

Do you have changes you want to make in your benefits elections or dependent(s)?

If YES, go to Steps 2 through 9 on how to make changes.

If NO, and you do not want to enroll in Health Benefits or Dependent Care FSA account for the next plan year, then you have no further actions to take and skip to Step 9 below.

Review the dependent(s) listed in your Open Enrollment Statement and dependent eligibility rules here.

Complete the Add Individual Dependent/Beneficiary Information in SF My Hub to add dependents or modify existing dependents.

Save and continue through all the screens and confirm at the end to submit your changes.

Submit copies of supporting documents. New dependents must have supporting documentation submitted with their elections in order to be enrolled (e.g. social security card, birth certificate, certified marriage certificate).

Start by reviewing the Service Areas for the medical plans available to you. There are five (5) options to choose from, four (4) HMO plans and one (1) PPO plan.

• Compare in-network providers for each HMO plan by clicking here.
• View a summary of benefits for all medical plans here.
• Use the Benefits Plan Comparison Tool available on SF My Hub. 

Once you’ve made your decision, select your plan and follow the instructions for enrollment through SF My Hub.

Review the Vision benefits options and rates here. You must be enrolled in a medical plan to receive basic vision benefits.

Enrollment in the VSP Premier Plan requires that all dependents enrolled in medical coverage be enrolled in the VSP Premier Plan.

Select your plan and follow the instructions for enrollment through SF My Hub.

Review your Dental benefit options below. To review Dental Benefits costs click here. Follow the instructions for enrollment through SF My Hub.

To contribute to a Flexible Spending Account (FSA) for the 2027 plan year, you must re-enroll during Open Enrollment.

For your Healthcare FSA, you can contribute up to $3,400 on a pre-tax basis.

For the Dependent Care FSA, if your annual salary is $160,000 or less, you can contribute between $250 and $7,500 on a pre-tax basis. If your salary exceeds $160,000, the IRS classifies you as a highly compensated employee, and your contribution limit will be between $250 and $3,300. SFHSS may adjust your contribution limit if you are not eligible for the higher amount.

Would you like to set aside pre-tax dollars in an FSA to cover Healthcare and/or Dependent Care expenses?

• If YES: Decide how much you want to contribute, then complete the Health Care FSA section on SF My Hub. 
• If NO: Continue to the next step to make changes to other benefits.

Members of the City and County of San Francisco and the Superior Court of San Francisco can schedule a personalized session with Workterra by visiting workterravboe.com or calling at (833) 711-4498. 

Starting October 1st: To enroll in voluntary benefits, access the Workterra application at https://myapps.sfgov.org and click on the Workterra tile where you can self-enroll, dis-enroll, or confirm any existing elections.
 

After Open Enrollment ends, you’ll receive a Health Benefits Enrollment Confirmation Statement by email (???) in December. Carefully review it to ensure there are no administrative errors. Only administrative errors may be corrected, and all correction requests must be submitted by December 31. Changes made during Open Enrollment become effective on January 1 of the following year.

These are optional add-on benefits beyond your employer-paid coverage that provide additional financial protection or services. Enrollment is paid by you through payroll deductions.

To learn more, you can schedule a personalized session with Workterra at workterravboe.com or by calling (833) 711-4498. Starting October 1, you can enroll in voluntary benefits through https://myapps.sfgov.org by selecting the Workterra tile, where you can enroll, disenroll, or review your current elections. Click below to visit the Voluntary Benefits webpage.

Pre-Tax Flex Benefit Options

The benefits listed below are paid pre-tax for an enrolled employee, spouse, children and stepchildren. These benefits are paid post-tax for an enrolled domestic partner and the children of a domestic partner.

Taxable Flex Benefit Options

1 Evidence of Insurability (EOI) is not required for new hires or newly eligible employees. 2 PLACEHOLDER

If you are a member of the Municipal Executives Association (MEA), you receive a Management Cafeteria Plan that provides you with flexible (flex) credits. The amount of these credits depends on the medical plan and coverage tier you choose. The flex credits will help pay for your eligible benefits premium. You do not need to enroll in health benefits to receive your flex credits.

Some union contracts provide Long-Term Disability (LTD) Insurance. A long-term disability is an illness or injury that prevents you from working for an extended period of time. LTD insurance may replace part of your lost income by paying you directly on a monthly basis. LTD payments will be reduced if you qualify for other sources of income, such as workers' compensation or state disability benefits. LTD coverage begins the first day of the month following six (6) months of employment.

Some union contracts provide you with employer-paid life insurance.

Outline of Life Insurance Plan Basics

1If your bargaining unit or unrepresented classes are not listed above, you do not have employer-paid group life insurance. 2Fire and Police employees represented by MEA have other life insurance benefits.

This is a general summary. For a complete list of bargaining units with Group Life Insurance benefits and to view plan documents, go to sfhss.org/group-life-insurance or call New York Life at (800) 225-5695.

Your health plan offers many free or low-cost benefits to support preventive care, healthy living, mental health, and overall well-being. For more information, visit sfhss.org/using-your-benefits/using-your-benefits-employees.

Your Health Plan Offerings 

Find the right service and care you need:

• Acupuncture
• Chiropractic care
• Diabetes Prevention
• Gender Affirming Care
• Gym Discounts
• Healthy Eating & Nutrition
• Lifestyle Coaching
• Mental Health & Substance Use Disorder Benefits*
• Pregnancy & Lactation
• Tobacco Cessation
• Weight Management Programs

*As a result of the mental health parity law, there are no yearly or lifetime dollar amounts for Mental Health and Substance Abuse services.

Employee Assistance Program (EAP)

Employee Assistance Program (EAP) Counselors are available Monday through Friday, 8 a.m. to 5 p.m. for confidential counseling and consultation. Employees can also access services through the EAP 24/7. Guidance Consultations are available 24/7 for confidential assessment and referral.

If you think you need help, or are having difficulty accessing Mental Health or Substance Abuse services
through your health plan, call EAP at (628) 652-4600.

For urgent Mental Health issues, members should call 911 or go to the nearest hospital emergency room.

Visit us at sfhss.org/eap for more resources. We're Here for You!

Individual Services

• Short-Term Solution Focused on Counseling for Individuals and Couples
• Assessment and Referrals
• Consultation and Coaching
• Mental Health Benefit Advocacy and Navigation

Organizational Services

• Management Consultation and Coaching
• Employee Mediation
• Critical Incident Response
• Workshops and Trainings

COBRA

Under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA), if you don’t have holdover rights or if your holdover rights have ended, you may still be eligible to continue your medical, dental, and vision coverage for yourself and your eligible dependents at your own expense. Current-year FSAs (Flexible Spending Accounts) may also be COBRA-eligible. For COBRA information, visit padmin.com or call (800) 688-2611.

You may elect to continue healthcare coverage through COBRA if coverage is lost due to:

• Voluntary or involuntary termination of employment (except for gross misconduct)
• Hours of employment reduced, making employee ineligible for employer health coverage

Your covered spouses or domestic partners may also elect to be covered under COBRA if coverage loss is due to:

• Voluntary or involuntary termination of the employee’s employment (except for misconduct)
• Divorce, legal separation, or dissolution of domestic partnership from the covered employee
• Death of the covered employee

Your covered dependent children may elect COBRA coverage if healthcare coverage is lost due to:

• Loss of dependent child status under the plan rules
• Voluntary or involuntary termination of the employee's employment (except for misconduct)
• Hours of employment reduced, making the employee ineligible for employer health coverage
• Parent’s divorce, legal separation, or dissolution of domestic partnership from the covered employee
• Death of the covered employee

COBRA Notification and Election Time Limits

If you and any enrolled dependents lose SFHSS coverage due to separation from employment, P&A Group will notify you of the opportunity to elect COBRA coverage. You or your dependent has 60 days from the COBRA notification date to complete enrollment and continue coverage. Coverage will be retroactive to the date of the COBRA-qualifying event, so there is no break in coverage. Your coverage ends on the last day of the coverage period in which your employment terminates. However, if your termination date falls on the first day of the coverage period, your coverage ends that same day. If your enrolled dependent loses coverage due to divorce, dissolution of partnership, or aging out, you or your dependent must notify P&A Group within 30 days of the qualifying event and request COBRA enrollment information.

Paying for COBRA

If you are a covered individual enrolled in COBRA, you are responsible for paying your required health insurance premium payments directly to P&A Group. Your employer does not subsidize COBRA premiums.

Duration of COBRA Continuation Coverage

If you enroll in COBRA coverage, it is generally available to you for up to 18 months. However, certain qualifying events or a second qualifying event that occurs during your initial coverage period may allow you to extend your coverage for up to 36 months.

If you are eligible for less than 36 months of federal COBRA, you may also qualify for Cal COBRA. In any case, your total continuation coverage under both federal and California COBRA cannot exceed 36 months.

If you are disabled on the date of your qualifying event or become disabled within the first 60 days of COBRA coverage, you may be eligible for up to 29 months of coverage. Starting in the 19th month, your premium cost will increase to 150 percent of the group rate.

Flexible Spending Accounts and COBRA

To continue your FSA benefits under COBRA, your year-to-date contributions must exceed your year-to-date claims as of your employment termination date. To keep your FSA active, you must enroll in COBRA and continue making your biweekly contributions along with a 2 percent administrative fee. Your COBRA Flexible Spending Account contributions will be made on a post-tax basis.

Termination of COBRA Continuation Coverage

COBRA coverage will end if:

• You obtain coverage under another group plan
• You fail to pay the premium required under the plan within the grace period
• The applicable COBRA period ends

Covered California: Alternative to COBRA

If you are not eligible for SFHSS coverage, you should consider getting health insurance through the state exchange, Covered California. You may qualify for tax credits or other financial assistance to help make coverage more affordable.
For more information about Covered California health plans, call (800) 300-1506 or visit coveredca.com.

Holdover Rights

If you are placed on a holdover roster, you may be eligible to continue your SFHSS medical, dental, and vision coverage for yourself and your covered dependents. Eligibility requirements include:

1. You must certify each year that you are unable to obtain other health coverage.
2. You must pay your premium contributions by the due date listed on the Health Coverage Calendar. Your rates may increase each plan year.

Your premium contributions are deducted from your paycheck every two weeks and are paid at the same time as your coverage period. Your Flexible Spending Account deductions only occur on pay dates during each tax year.

If you take an approved unpaid leave of absence, you must arrange to make any premium payments that were previously deducted from your paycheck directly to SFHSS. Your premium contributions are due no later than the pay date for the coverage periods listed in the Health Coverage Calendar.

2026 Health Coverage Calendar

SFHSS

1145 Market Street, 3rd Floor
San Francisco, CA 94103
Tel: (628) 652-4700
Fax: (628) 652-4701

SFHSS Telephone Hours
Monday, Tuesday, Wednesday, and Friday: 9:00 a.m. to 12:00 p.m. and 1:00 p.m. to 5:00 p.m.
Thursday: 10:00 a.m. to 12:00 p.m. and 1:00 p.m. to 5:00 p.m.

Update Your Information

For changes in family status, new hires, and more, please visit sfhss.org/contact-us.

Well-Being

1145 Market Street, 2nd Floor
San Francisco, CA 94103

Tel: (628) 652-4650
Fax: (628) 652-4601
well-being@sfgov.org
sfhss.org/well-being

Employee Assistance Program

1145 Market Street, 2nd Floor
San Francisco, CA 94103
Tel: (628) 652-4600 (24/7)
Fax: (628) 652-4601
eap@sfgov.org
sfhss.org/eap

Health Service Board

Attn: Board Secretary
1145 Market Street, 3rd Floor
San Francisco, CA 94103
Tel: (628) 652-4646
Fax: (628) 652-4702
health.service.board@sfgov.org
sfhss.org/health-service-board

CCSF Payment Portal

To make health premium payments online, visit the City and County of San Francisco Payment Portal at sfhss.org/how-make-payment

Medical Plans

Health Net CanopyCare HMO
(833) 448-2042
healthnet.com/sfhss
Group: G0727A

Kaiser Permanente HMO
(800) 464-4000
choose.kp.org/sfhss
Group: 888 (Northern CA)
Group: 231003 (Southern CA)

Blue Shield of California Trio HMO
(800) 357-1901
blueshieldca.com/sfhss
Group: W0051448

Blue Shield of California Access+ HMO
(800) 357-1901
blueshieldca.com/sfhss
Group: W0051448

Blue Shield of California PPO (Non-Medicare)
(888) 499-5532
blueshieldca.com/sfhss
Group: W0051448

Blue Shield of California MAPD PPO (Medicare)
(800) 370-8852
blueshieldca.com/sfhss
Group: W0051448

Dental & Vision Plans

Delta Dental PPO
(888) 335-8227
deltadentalins.com/ccsf
Group 01673

DeltaCare USA DHMO
(800) 422-4234
deltadentalins.com/ccsf
Group 71797

UHC Dental DHMO
(800) 999-3367
whyuhc.com/sfhss

VSP Vision Care
(800) 877-7195
www.vsp.com
Group 12145878

FSAs and COBRA

P&A Group
(800) 688-2611
padmin.com

Voluntary Benefits

Workterra Open Enrollment Services
(833) 711-4498
workterravboe.com

Workterra Newly Eligible/Life Event Services
Workterra New Hire Consultations
(866) 528-5360
ccsfvboe.com

Workterra Customer Service
(888) 604-3771

LTD and Group Life Insurance

New York Life LTD
Policy: LK980417

General Customer Service or Claim Status
(800) 695-4226, Option #1, Extension #3
mynylgbs.com

To File a Disability Claim
(888) 842-4462
nyl.com/disability-claim

New York Life Employer-Paid Group Life Insurance
Policy: FLX980556
(800) 225-5695
When prompted, say “Claims” to be directed to the appropriate department.

Other Agencies

Pension Benefits

SFERS (San Francisco Employees' Retirement System)
Tel: (415) 487-7000
Toll Free: (888) 849-0777
mysfers.org

CalPERS
(888) 225-7377
calpers.ca.gov

CalSTRS
(800) 228-5453
calstrs.com

PARS
(800) 540-6369
pars.org

Health Insurance Exchange
Covered California
(800) 300-1506
coveredca.com