Plan Documents

 
Title Date Sort descending
UHC PPO (City Plan) - Prescription 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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2023 P&A Group Flexible Spending Account Claim Form
City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees, 2023
Download
2019 Form P&A Group Debit Card Request
City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees, 2019
Download
UHC PPO (City Plan) - Prescription Drug Plan 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
Summary Aetna Basic Life Insurance Superior Court SEIU $25,000
Superior Court of SF Employees, 2021, 2020, 2019
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2020 The Hartford Group Life Insurance Flyer
City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees, 2020
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Summary Aetna Basic Life Insurance Teamsters 856 $50,000
City & County of SF Employees, 2021, 2020, 2019
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Summary Aetna Basic Life Insurance SEIU 1021 $50,000
City & County of SF Employees, 2021, 2020, 2019
Download