Female Public Utilities commission uniformed watershed keeper standing next to Watershed Wheel at Crystal Springs Watershed.


The City and County of San Francisco offers eligible employees the opportunity to enroll themselves and eligible family members in medical, dental, vision and Flexible Spending Account (FSA) benefits. Enrollment must take place within 30 days of the start work date, no later than 30 days after a qualifying event, or during the annual Open Enrollment period, which takes place each year during the month of October.

If you have a Qualifying Life Event outside of the Open Enrollment period, you can make your Life Events updates online through the Employee Portal. Visit our Qualifying Life Event page for more information.

Eligibility Rules

The following are eligible to participate in the San Francisco Health Service System (SFHSS) as members:

  • All permanent employees of the City and County of San Francisco whose normal work week is not less than 20 hours.
  • All regularly scheduled provisional employees of the City and County of San Francisco whose normal work week is not less than 20 hours.
  • All other employees of the City and County of San Francisco, including temporary exempt “as needed” employees, who have worked more than 1,040 hours in any consecutive 12 month period and whose normal work week is not less than 20 hours.
  • Elected Officials.
  • All members of designated boards and commissions during their time in service to the City and County of San Francisco as defined in San Francisco Administrative Code Section 16.700(c).
  • All officers and employees as determined eligible by the governing bodies of the San Francisco Transportation Authority, San Francisco Parking Authority, and Treasure Island Development Authority, Superior Court of San Francisco and any other employees as determined eligible by ordinance.
  • All other employees who are deemed 'full-time employees' under the federal Patient Protection and Affordable Care Act (section 498OH).

Documents & Forms



City and County of San Francisco employees can choose from Health Net CanopyCare HMO, Blue Shield of California Access+ HMO, Blue Shield of California Trio HMOKaiser Permanente HMO or Blue Shield of California PPO health plans.

Please note that Health Net CanopyCare HMO, Blue Shield of California HMO and Kaiser Permanente HMO require enrollees to live or work in a zip code serviced by their plan. Blue Shield of California PPO does not have service area requirements.


SFHSS recognizes that dental benefits are a very important part of your healthcare coverage and for maintaining your good overall health. Consequently, City & County of San Francisco employees have three dental plans to choose from: Delta Dental PPO, DeltaCare USA DHMO or UnitedHealthcare Dental DHMO

PPO-style dental plans, like Delta Dental PPO, allow you to visit any in-network or out-of-network dentist. DHMO (short for Dental Health Maintenance Organization) plans require you to receive all your dental care from within a network of participating doctors.


All SFHSS members and their dependents who are enrolled in an SFHSS medical plan are automatically enrolled in the VSP Basic Plan at no additional cost. We also offer an enhanced plan called the VSP Premier Plan at an additional cost based on the number of members enrolled in coverage.

If you do not enroll in a medical plan, you and your dependents cannot access VSP Vision Care benefits.

Additional Benefits

SFHSS understands that there are more areas in your life that need additional services, care or coverage. To meet your expanding needs, we offer a large spectrum of additional benefits designed to complement, protect and enhance your quality of life and financial security for your family due to unforeseen events. 

Additional benefits range from Life and Disability insurance, which comes with different union memberships, Flexible Spending Accounts (FSAs), which allow you to spend pre-tax dollars on health expenses and/or child or elder care, the Employee Assistance Program (EAP), which provides counseling and other mental health services to employees, and a Surrogacy and Adoption Assistance Plan.

Voluntary Benefits

Voluntary Benefits offer a variety of competitive, group-priced plans and services designed to help protect you and your family in the form of additional insurance coverage and consumer protection services that can help relieve some of the financial pressures brought on by unexpected events.

SFHSS has partnered with WORKTERRA to offer quality insurance plans at the best cost.

  • San Francisco Health Service System reviewed and approved
  • For new hires, guaranteed issue - no medical history or exam required
  • Discounted group premium rates
  • Optional enrollment - if you choose to enroll, premiums can be paid by payroll deduction

Go to Voluntary Benefits for a complete list of plans and services.

Employee Benefits Guide

Posted On

May 1, 2024