Welcome to Open Enrollment 2020!
If after reviewing your step-by-steps and you have no changes to make to your benefits, then you have no further actions to take.
We want your Open Enrollment to be convenient and easy. To help, follow the step-by-step enrollment guide below. The steps follow along with your Open Enrollment Booklet that you received in the mail.
By following each step, you can navigate your benefits and decide to make any changes you want or need to make.
If you received an Open Enrollment Application Form (see the Open Enrollment Forms below), you can submit your completed form and supporting documentation by fax or mail.
If you received instructions on how to enroll online, visit the eBenefits page for Retirees for more information on how to get started.
Open Enrollment ends on October 30, 2020 at 5pm PST.
Step 1 - Review your Open Enrollment Letter and Rates
Review your Open Enrollment Letter for your current medical, dental and vision elections. New 2021 rates are on the back of your Open Enrollment letter. You can also find 2021 rates below.
Step 2 - Add or Drop Dependents
Review the dependent(s) listed in your enclosed Open Enrollment letter. If you need to add or drop a dependent, review the dependent eligibility rules here.
Complete box 5 (Retirees without Medicare) or box 6 (Retirees with Medicare) on your Open Enrollment Application Form (see the Open Enrollment Forms below).
If you are enrolling in eBenefits, add dependents or modify existing dependents on the Review Dependents page.
New dependents must have supporting documentation submitted with their elections in order to be enrolled (e.g. birth certificate, certified marriage certificate).
Step 3 - Are You or Your Dependent About to Become Medicare-Eligible?
If you or your dependent are approaching age 65 and about to become Medicare-eligible and you are not yet enrolled in Medicare, you must enroll in Medicare through the Social Security Administration online at ssa.gov or by calling (800) 772-1213.
If no, be sure to apply for Medicare at least three months before your 65th birthday.
Upon eligibility for Medicare, proof of enrollment in Medicare Part A & B are required to maintain your SFHSS benefits. Review Medicare Basics and FAQs on page 4 of your Retiree Open Enrollment Booklet.
Be sure to submit proof of Medicare enrollment by mailing a copy of your Medicare card or letter to SFHSS.
What you should know when adding dependents
When adding dependents, remember that not all relationship types are eligible to receive benefits. You can list other relationships that are not eligible for benefits as emergency contacts.
To find out if your dependent is eligible for coverage, please refer to the Eligibility Relationship Types table.
Step 4 - Making Changes to Your Health Plan Benefits
Start by reviewing the Service Areas of the medical plans available to you. If you are a Retiree without Medicare, go to page 6 in your Open Enrollment Booklet. If you are a Retiree with Medicare, go to page 7.
Review coverage details on pages 4 and 5 of your Open Enrollment Benefits Booklet and review the rates for available plans in your area on page 2 of your Open Enrollment letter.
Next, review the Medical Plan benefits for 2021. Retirees without Medicare go to pages 8 to 11. Retirees with Medicare go to pages 12 to 13. Review your rates on the back of your enclosed Open Enrollment letter. You can also view your rates below.
Select your plan by checking the health plan in box 2 or box 3 of the Open Enrollment Application Form (see the Open Enrollment Forms below).
If you are enrolling online, select your plan and complete Choose a Medical Plan page in eBenefits.
Retirees without Medicare members can select from the following medical plans: UnitedHealthcare PPO (City Plan), Blue Shield of California's Trio HMO or Access+ HMO or Kaiser Permanente HMO.
- Blue Shield of California HMO
Click here to visit Blue Shield of California's SFHSS member site. Access+ HMO plan members call (855) 256-9404. Trio HMO plan members call (855) 747-5800.
Click here to schedule a 1:1 meeting with Blue Shield of California to get questions answered about the Access+ HMO and Trio HMO plans.
- UnitedHealthcare PPO
You can visit UHC PPO's SFHSS member site here or call (866) 282-0125.
Visit the UHC's Virtual Education Center for resources and info. about 2021 plans here.
UHC is offering exclusive Office Hours for members during enrollment. Download the schedule here.
- Kaiser Permanente HMO (California)
Click here to visit Kaiser Permanente's SFHSS member site or call (800) 464-4000.
Kaiser Permanente is offering exclusive Office Hours for SFHSS members. Download the schedule for October here.
- Kaiser Permanente Hawaii (non-Medicare Eligible Retirees): (808) 423-5955
- Kaiser Permanente Northwest (non-Medicare Eligible Retirees): (800) 813-2000
- Kaiser Permanente Washington (non-Medicare Eligible Retirees): (888) 901-4636
Retirees with Medicare members can select from the following medical plans: UnitedHealthcare Medicare Advantage PPO or Kaiser Permanente HMO.
- UnitedHealthcare Medicare Advantage PPO
You can visit UHC PPO's SFHSS member site here or call (877) 259-0493.
- Kaiser Permanente Senior Advantage (California)
Click here to visit Kaiser Permanente Senior Advantage's SFHSS member site or call (800) 443-0815.
Kaiser Permanente is offering exclusive Office Hours for Retiree members. Download the schedule for October here.
- Kaiser Permanente Senior Advantage Hawaii: (800) 805-2739
- Kaiser Permanente Senior Advantage Northwest: (877) 221-8221
- Kaiser Permanente Senior Advantage Washington: (888) 901-4600
Click below to see plan documents for plan year 2021.
Step 5 - Vision Benefits
Review the Vision benefits options and rates on page 14 of your Open Enrollment Benefits Booklet. Remember, you must be enrolled in a medical plan to receive Vision benefits.
Enrollment in the VSP Premier Plan requires that all dependents enrolled in a medical coverage be enrolled in the VSP Premier Plan.
Complete box 4 or 5 on your Open Enrollment Application Form or complete the Enroll in a Vision Premier Plan page in eBenefits.
Step 6 - Dental Benefits
Retiree members can select from the following dental plans: Delta Dental PPO, DeltaCare USA DHMO or UHC Dental DHMO.
Click on the plans below for more details.
Step 7 - Complete and Submit Your Elections
If your packet includes eBenefits enrollment instructions, complete and submit your elections online. If you received an Open Enrollment Application Form, mail or fax your completed form and documentation (do not send originals) to SFHSS.
Our offices are currently closed to the public due to COVID-19.
Our mailing address is 1145 Market Street, 3rd Floor, San Francisco, CA 94103 or fax to (628) 652-4701.
Open Enrollment Application Form
Step 8 - Confirmation Letter
After Open Enrollment ends, you’ll receive a Confirmation Statement in the mail from SFHSS in December. Please review your Confirmation Statement to make sure your benefit elections are correct. Changes made during Open Enrollment take effect January 1, 2021.
Our offices are currently closed to the public due to COVID-19.
Telephone Hours: Monday, Tuesday, Wednesday and Friday from 9am to 12pm and 1pm to 5pm and Thursday from 10am to 12pm and 1pm to 5pm.
If you are unable to enroll online, you can also fax or mail your Open Enrollment Application Form and supporting documentation (do not send originals) to (628) 652-4701.