Plan Documents

 
Title Date Sort ascending
2018 SFHSS Member Rules
City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Getting Ready to Retiree, Retirees with Medicare, Retirees without Medicare, Superior Court of SF Employees, Blue Shield of California HMO, Access+ HMO, Trio HMO, 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 PPO, UHC City Plan PPO, UHC Medicare Advantage PPO, VSP Vision, 2018
December 10, 2018 Download
2019 Retirees with Medicare Enrollment Form
Retirees, 2019
December 10, 2018 Download
2019 Retirees without Medicare Enrollment Form
Retirees, 2019
December 10, 2018 Download
2019 SFUSD Enrollment Form
SF Unified School District Employees, 2019
December 10, 2018 Download
2019 Municipal Executives Enrollment Form
Municipal Executive Employees, 2019
December 10, 2018 Download
2019 City College of San Francisco Enrollment Form
City College of SF Employees, 2019
December 10, 2018 Download
2019 City & County of San Francisco Enrollment Form
City & County of SF Employees, 2019
December 10, 2018 Download
HIPAA Authorization to Disclosure Protected Health Information to Family Members
City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Superior Court of SF Employees, 2019
December 10, 2018 Download