Plan Documents

 
Title Date Sort ascending
2023 SFHSS Access+ HMO EOC_w_Endorsement
City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Retirees without Medicare, Superior Court of SF Employees, Blue Shield of California HMO, Access+ HMO, 2023
Download
2024 UHC MAPD PPO Provider Access Information
Retirees, Retirees with Medicare, 2024
Download
2024 Certification of Federal Tax Dependent Status Declaration Form (Domestic Partner or Child)
City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, 2024, 2023
Download
2024 UHC Choice Plus Medicare-Eligible Not Enrolled Summary of Benefits & Coverage (Outside of CA)
Retirees, Getting Ready to Retiree, Retirees with Medicare, Retirees without Medicare, UnitedHealthcare, UHC Medicare Advantage PPO, UHC PPO - Companion Plan, 2024
Download
2024 UHC Choice Plus Medicare-Eligible Not Enrolled Summary of Benefits (Outside of CA)
Retirees, Getting Ready to Retiree, Retirees with Medicare, Retirees without Medicare, UnitedHealthcare, UHC Medicare Advantage PPO, UHC PPO - Companion Plan, 2024
Download
2024 UHC Select Plus and Choice Plus Medicare-Eligible Not Enrolled Summary Plan Description
Retirees, Getting Ready to Retiree, Retirees with Medicare, Retirees without Medicare, UHC Medicare Advantage PPO, UHC PPO - Companion Plan, 2024
Download
2024 Retiree Rate Sheets
Retirees, Getting Ready to Retiree, Retirees with Medicare, Retirees without Medicare, Health Net CanopyCare HMO, Blue Shield of California HMO, Access+ HMO, Trio HMO, Blue Shield of California PPO, Blue Shield of California PPO 20, Blue Shield of CA PPO - Out of Area, Kaiser Permanente HMO, Kaiser Permanente HMO - California, Kaiser Permanente HMO - Multi-Region, Kaiser Permanente Senior Advantage HMO - California, Kaiser Permanente Senior Advantage HMO - Multi-Region, UnitedHealthcare, UHC Medicare Advantage PPO, UHC PPO - Companion Plan, UHC Doctors Plan EPO, UHC Select Network EPO, VSP Vision, 2024
Download
2024 San Francisco Unified School District Rate Sheets
SF Unified School District Employees, Health Net CanopyCare HMO, Blue Shield of California HMO, Access+ HMO, Trio HMO, Blue Shield of California PPO, Kaiser Permanente HMO, VSP Vision, 2024
Download