Open Enrollment is Here
Welcome to Open Enrollment for Plan Year 2020. Open Enrollment is your opportunity to enroll, change or drop health plans for you and your dependents and takes place from October 1-31, 2019. This year, we are excited to offer online enrollment for all City and County of San Francisco Active employees as well as a number of selected retirees.
If you received instructions to enroll online using eBenefts, click on the laptop below to get started:
Below you will find downloadable copies of each Benefits Guide, Open Enrollment Forms, links to Plan Documents for each plan provider and lots of other important information.
After reviewing plan documents, you can enroll in your benefits online using our new eBenefits system, which you can access 24/7 throughout the month of Open Enrollment.
Stay informed and get the most out of your benefits year-round by signing up for our eNews.
Blue Shield of CA Trio HMO Now Includes CPMC
When Trio HMO was first introduced in 2018 as a health plan option to SFHSS members, we learned that access to California Pacific Medical Center (CPMC) played an important decision in the election of your health plan. Because of this, we wanted to share the exciting news with you that CPMC has been recently added to the exclusive SFHSS Trio network – including the Mission Bernal Campus, the state-of-the art 1101 Van Ness Campus, and the Davies Campus. You can check to see if your providers are in the SFHSS Trio HMO network by visiting blueshieldca.com/triosfhss.
What's New in 2020
Medical and Vision Contributions Changing Premiums for the following plans will increase in 2020: UHC Medicare Advantage PPO; Kaiser Permanente Senior Advantage (California); Kaiser Permanente Retiree Plans in Hawaii and Northwest Regions and VSP Premier. Premiums for the following plans will decrease in 2020: Kaiser Permanente Retiree Plans in the Washington Region.
CPMC Medical Center Now Part of Blue Shield of CA Trio HMO Network
(for non-Medicare members only)
Trio HMO's network for SFHSS's Brown and Toland medical group members now includes California Pacific Medical Center (CPMC). This exclusive arrangement expands access to the new 1101 Van Ness, Davies and Mission Bernal campuses only.
2020 Benefit Enhancements for Blue Shield of California's Trio HMO and Access+ HMO Plans (for non-Medicare members only)
Blue Shield of California's Trio HMO and Access+ HMO plans now offer members the ability to receive, from participating retail pharmacies, certain no-cost vaccinations, including influenza (flu), HPV, pneumonia, meningitis, Tdap booster and shingles.
Nutritional Counseling Options through All SFHSS Health Plans
On January 1, 2020, all SFHSS health plans will offer Nutritional Counseling benefits. Blue Shield of CA Trio HMO and Access+ HMO members can receive nutritional counseling with or without a specific medical diagnosis. UHC PPO (City Plan) and UHC Medicare Advantage PPO plans will continue to offer up to four (4) nutritional counseling visits per year without a specific medical diagnosis. Kaiser Permanente (non-Medicare) and Kaiser Permanente Senior Advantage HMO will continue to offer telephonic nutritional coaching and comprehensive wellness coaching. Refer to your Evidence of Coverage or contact your health plan for more information.
UHC PPO (City Plan) Reducing In-Network Family Out-of-Pocket Maximum
(for non-Medicare members only)
UHC PPO (City Plan) will offer a lower in-network Family Out-of-Pocket Maximum in 2020 to better align with other plans offered by SFHSS. This will reduce the in-network Family Out-of-Pocket Maximum from $12,700 to $7,500 (twice the amount of the individual in-network Out-of- Pocket Maximum).
UHC Medicare Advantage PPO Post-Discharge Meal Delivery Benefit
UHC Medicare Advantage PPO members are eligible to receive up to 84 home-delivered meals (one time per calendar year), immediately following an inpatient hospitalization, when referred by a case manager. Meals are delivered to you by Mom's Meals NourishCare. Refer to your Evidence of Coverage or contact UHC directly for more information.
Routine and Post-Discharge Transportation Benefits
On January 1, 2020, UHC Medicare Advantage PPO and Kaiser Permanente Senior Advantage HMO will provide post-discharge transportation benefits for Medicare members. You may receive up to 24 one-way, non-medical trips (up to 50 miles per trip, with some restrictions). Refer to your Evidence of Coverage or contact UHC directly for more information.
Delta Dental PPO Offers Enhanced Coverage for Major Services from In-Network Dentists
Beginning January 1, 2020, enrolled retirees will now receive 60% (up from 50%) plan-paid co-insurance coverage when using a Delta Dental PPO network dentist for crown, denture, pontic, bridge and endodontic/root canal services. Individual member deductibles for services, excluding diagnostic and preventive care (e.g. annual check-ups, x-rays and covered cleanings), that are provided by Premier and out-of-network dentists have increased from $50 to $75 annually.
Best Doctors Discontinued as of December 31, 2019
The Health Service Board has elected to not renew the contract with Best Doctors for 2020. Please be aware that the second medical opinion benefit is available through all our health plans. For more information on obtaining a second medical opinion, refer to your Evidence of Coverage or contact your selected health plan.