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Plan Documents

 
Title Date
2020 Summary of Benefits and Coverage (SBC) UHC City Plan PPO Medicare-Eligible but Not Enrolled in Medicare (non-California)
Retirees, Kaiser Permanente HMO, UHC PPO (pre 2022), 2020
 Download
2019 Summary of Benefits (SOB) UnitedHealthcare Dental DHMO - Actively-employed
City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees,
Download
2020 Summary of Benefits and Coverage (SBC) - UHC PPO (City Plan) (Outside of Continental United States)
City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Superior Court of SF Employees, UnitedHealthcare, UHC PPO (pre 2022), 2020
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2020 Summary of Benefits and Coverage (SBC) - UHC PPO (City Plan) for Actively-enrolled (non-California)
City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Superior Court of SF Employees, UnitedHealthcare, UHC PPO (pre 2022), 2020
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2019 Summary of Benefits (SOB) UnitedHealthcare Dental DHMO - Retirees
Retirees,
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2019 Evidence of Coverage (EOC) UnitedHealthcare Dental DHMO - Actively-employed
City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees,
Download
2019 Evidence of Coverage (EOC) UnitedHealthcare Dental DHMO - Retirees
Retirees,
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2019 Summary of Benefits (SOB) Kaiser Permanente Senior Advantage HMO Washington (Medicare)
Retirees, Kaiser Permanente HMO, Kaiser Permanente Senior Advantage HMO - Multi-Region,
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