Plan Documents

 
Title Date Sort descending
2018 Form SFHSS Live or Work Rule Enrollment
City & County of SF Employees, Municipal Executive Employees, 2019, 2018
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2019 City & County of San Francisco Benefits Guide
City & County of SF Employees, 2019
Download
Summary SFHSS Adoption Surrogacy Plan
City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees, 2022, 2021, 2020, 2019, 2018, 2017
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2019 City & County of San Francisco Premium Rates
City & County of SF Employees, Blue Shield of California HMO, Kaiser Permanente HMO - Multi-Region, UHC PPO (pre 2022), 2019
Download
2020 The Hartford Long-Term Disability (LTD) Insurance Flyer
City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees, 2020
Download
UHC PPO (City Plan) - Foreign Claims Form
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), 2019, 2018
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2019 Form United Healthcare City Plan Mail-In Prescription
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), 2019, 2018
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UHC PPO (City Plan) - United States Claims Form
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), 2019, 2018
Download