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! Open Enrollment for your 2027 health benefits is here. SFHSS administers your Medical, Vision, Dental, Flexible Spending Accounts (FSA), and Voluntary Benefits.

This year, SFHSS encourages you to Find the Value in Your Benefits. Your plans include hidden gems that can help you meet your wellness goals—like using vision benefits for non‑prescription sunglasses, accessing acupuncture or chiropractic care without a referral, maternity programs with doula or midwife options, and extra dental cleanings through Delta Dental’s SmileWay program. You also have discounts on gyms, meal prep services, and more. Review your plan’s Summary of Benefits to uncover perks you may not have known about.

Open Enrollment is your once‑a‑year chance to change your coverage without a Qualifying Life Event. Compare plans, add or drop dependents, switch coverage, or waive it altogether. It’s also the perfect moment to update your beneficiaries. And remember—if you want to participate in an FSA next year, you must enroll or re‑enroll during OE and select your contribution amount.

Use the buttons below to view Important Dates and the schedule of Benefits Fairs.

MEDICAL

Health Net Leaving the California Health Insurance Market in February 2027

Health Net notified SFHSS on September 2, 2026, that it will leave the California market at the end of February 2027. All current Health Net members should choose a new medical plan during Open Enrollment. If you don’t switch plans, you may face coverage disruptions, including being auto‑assigned to a new primary care physician (PCP) starting March 1, 2027.

If you were planning to switch to Health Net, please reconsider to avoid disruption.

To keep your current PCP, you can enroll in a Blue Shield of California HMO plan and select your PCP during enrollment.

Premiums for Some Health Plans Increased at a Rate Higher Than The National Average

Several health plans have significantly increased their premiums for plan year 2027 due to the rising costs of health care. We encourage you to review all available medical plan options to see if a more affordable health plan can meet your needs. 

Kaiser Permanente HMO 

• Kaiser has expanded preventive and reproductive health benefits, including enhanced cervical cancer screening and updated fertility coverage for eligible members.
• New transportation support after hospital discharge for eligible members requiring medically appropriate ground transportation.

DENTAL

Last fall, SFHSS surveyed all active City and County and Superior Court employees to understand what matters most in a dental plan. Members overwhelmingly prioritized having a broad network of in‑network dentists. We used the survey results to design a Request for Proposal (RFP) for our dental PPO business. Through the RFP process, we learned that if we switched to another plan, almost 30% of our members would be out-of-network, which would require more members to pay higher out-of-network rates for services. For that reason, the Health Service Board chose to keep the dental PPO plan we already have and renew our contract with Delta Dental for our PPO dental plan.

FLEXIBLE SPENDING ACCOUNTS (FSA)

Reminder - The Dependent Care FSA Limit Has Increased!

To maximize the increased tax savings for all our members, SFHSS will continue to split the maximum contribution eligibility requirements.

• Members who gross less than or equal to $160,000 annually, the maximum contribution for the Dependent Care FSA is $7,500 for single/married filing jointly; $3,750 for married filing separately. 
• Members who gross more than $160,000, you are deemed a Highly Compensated Employee (HCE) by the Internal Revenue Service (IRS) and the maximum contribution for the Dependent Care FSA is $3,300.

VOLUNTARY BENEFITS

$200,000 Guarantee Issue for Employee-Paid New York Life Supplemental Life Insurance Extended

If you’ve ever been denied insurance due to a medical condition or requirement to complete a health assessment, then you know how challenging it can be to secure life insurance that will protect your family and finances. Back by popular demand, New York Life is extending the $200,000 Guarantee Issue for Supplemental Life Insurance for the 2026 Open Enrollment effective starting January 1, 2027. If you missed out last year, this is your second chance to sign up.

*NEW* Metlife + Aura Identity and Fraud Protection 

Metlife + Aura Identity and Fraud Protection will replace ID Shield and AllState Identity Protection effective January 1, 2027. With this change, members will receive enhanced benefits for identity and fraud protection at the same or lower premium. 

*NEW* Metlife Legal Plan 

Metlife Legal Plan will replace Legal Shield effective January 1, 2027. Metlife Legal has enhanced benefits for a lower premium than Legal Shield.

Learn more about both these new benefits from Metlife and how you can enroll at https://sfhss.org/voluntary-benefits.

1. Login to SF My Hub and select the Open Enrollment tile to review or make changes.
2. Complete your benefit elections and print or save your Confirmation Receipt of Submission for your records.
3. If you’re not making changes to your health benefits, nor adding or dropping dependents, and you don’t want to to have any Flexible Spending Account(s), then no action is needed. Your current elections will automatically carry over to the next plan year.
4. You will receive a Confirmation Email notice by early December of this year.

You can find more detailed instructions on how to navigate the online health benefits enrollment process here: SF My Hub Navigation Instructions.

Not sure which plan is best for you? 

You can schedule a personal consultation with a plan representative to ask about your specific situation to decide if you want to switch to another plan or keep the plan you have. Click the buttons below to schedule a consultation with a plan representative or you can call them directly under Key Contacts.

Delta Dental is hosting two webinars for our members to ask questions. You can find them on our OE calendar above. 

Health Maintenance Organization (HMO)

An HMO is a medical plan that offers benefits through a network of participating physicians, hospitals and other healthcare providers working closely together to help coordinate your care. You select a Primary Care Physician (PCP) who will coordinate all non-emergency care and services including access to certain specialists, programs and treatments that are in the same medical group or network. You must live or work in a ZIP code serviced by the plan to enroll. Under these plans, there is no plan year deductible before accessing your benefits. Most services are available for a fixed dollar amount known as a "co-payment".

Preferred Provider Organization (PPO)

A PPO is a medical plan that provides access to a network of health care providers (doctors, hospitals, labs, pharmacies, etc.) known as preferred providers. You pay less when you to seek services from preferred providers. However, the plan allows you the option of seeing non-preferred providers, but requires you to pay a higher percentage of the bill. Generally, when compared to HMO medical plans, PPOs usually result in higher out-of-pocket costs and a deductible will apply to many services. Instead of having a fixed co-pay for medical services, your cost share may vary as a percentage of what the provider charges, known as a “coinsurance”. You will need to pay your plan year deductible prior to paying your coinsurance for the applicable service.

Click the following buttons to learn about the different HMO and PPO plans SFHSS offers.

SFHSS offers two vision plans for members and dependents who are enrolled in a SFHSS medical plan. Vision coverage is provided through Vision Service Plan (VSP). 

Vision Service Plan - Basic

The VSP Basic Plan is included with enrollment in all SFHSS medical plans. Members are eligible for a vision exam once a year, and either one set of contacts or a pair of eyeglasses frames/lenses every other calendar year. Eligible dependent children are covered in full for polycarbonate prescription lenses.

Vision Service Plan - Premier

Members may buy-up to the VSP Premier Plan that includes coverage for either one set of contacts or a pair of eyeglasses frames/lenses every calendar year. The VSP Premier Plan provides a higher allowance for a frame and lenses or contacts. If a member buys up to the VSP Premier Plan, member’s dependents will also be enrolled in the VSP Premier Plan.

No Medical Plan = No Vision Benefits

If you do not enroll in an SFHSS medical plan, you and your dependents are not eligible to enroll in VSP Vision Care plans offered through SFHSS. You and your dependents must choose the same vision plan option.

SFHSS offers three dental plan options for our members to choose from. Two are Dental Health Maintenance Organization (DHMO) plans and one is a Dental Preferred Provider Organization (DPPO) plan.

DHMO Dental Plans

Similar to medical HMOs, Dental Health Maintenance Organization (DHMO) plans require you to receive all of your dental care from their network of participating dental providers. These networks are smaller than dental PPO networks. Before you elect a DHMO plan, make sure the plan’s network includes your chosen dentist, and that dentist is accepting new patients.

Under DHMO plans, services are covered either at no cost or with a fixed co-pay. Out-of-pocket costs for these plans are generally lower than PPO plans. 

Dental PPO Plan

A Dental PPO plan allows you the flexibility to visit any in-network or out-of-network dentist. The plan covers a higher percentage of the costs for covered services when you go to an in-network PPO dentist. Out-of-network providers may bill you for the difference between your co-insurance and Delta Dental's reimbursement, which is based on a coverage limit for the service.

SFHSS offers two types of FSAs, administered by the P&A Group:

Health Care FSA (HCFSA)
Enables you to use pre-tax dollars to pay for eligible medical expenses not covered by insurance for you and your dependents, such as copayments, prescription medications, and certain over‑the‑counter items.

You can contribute up to $3,400 on a pre-tax basis for plan year 2027.

Dependent Care FSA (DCFSA)
Enables you to pay for childcare or care for an elderly family member who is incapable of self‑care, also on a pre‑tax basis.

• If your annual salary is equal to or less than $160,000, 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 (HCE), 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.

Members of the Municipal Executives Association (MEA) receive a Management Cafeteria Plan that provides flexible credit. The amount of flexible credit varies based on the medical plan and coverage tier the MEA member is enrolled in. Enrollment in health benefits is not required to receive flexible credits. These credits can be applied toward both pre-tax health benefits and post-tax benefits such as voluntary benefits. All or a portion of the listed premium amount may be covered by the Flex Credits MEA members receive. You may choose any combination to fit your needs and budget. If the premium contributions for your benefit choices cost more than your flex credits, you pay the balance from your salary. If your benefits choices cost less than your available flex credits, you will receive cashback as taxable, non-pensionable earnings in your paycheck.

SFHSS negotiates group discount rates for voluntary benefits, which are additional insurance plans that offer financial protection for you and your family. Premiums for these plans are paid by post-tax payroll deductions for your convenience.

Schedule a personalized consultation with Workterra by visiting workterravboe.com or calling at (833) 711-4498. 

Starting October 1st: You can self-enroll, dis-enroll, or confirm any existing voluntary benefits elections through the Workterra application at https://myapps.sfgov.org by clicking on the Workterra tile.
 

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. Click the button below to learn more. 

Some active employees of the City and County of San Francisco and the Superior Court of San Francisco may be eligible for Employer-Paid Group Life Insurance benefits. Eligibility depends on the labor union to which a member belongs. Click the button below to learn more.

Well-Being Benefits

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, click the Well-Being Benefits button below. 

Employee Mental Health Benefits

Your health plan provides Mental Health and Substance Abuse Disorder resources. To explore confidential support, self-care tools, benefits, and educational resources click the Employee Mental Health Benefits button below. 

Active employees can access the city Employee Assistance Program (EAP) for individual and organizational counseling through the Department of Human Resources. For information or to access services, call (628) 652-4600 or email: eap@sfgov.org. 

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

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. Click the button below to view the 2027 Health Coverage Calendar.

Telephone or In-Person Office Support

We strongly encourage you to enroll online. If online enrollment is not an option, you may:

• Fax your Open Enrollment Application Form and supporting documents to (628) 652-4701
• Deliver them in person to our Drop Box, available from 9 a.m. to 4:30 p.m. at 1145 Market Street, 3rd Floor, San Francisco, CA 94103

Our SFHSS Benefits Analysts are available by phone or in-person to assist members.