Plan Documents
| Title | Date Sort ascending | |
|---|---|---|
| 2019 Form P&A Group Debit Card Request City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees, 2019 |
Download | |
| 2023 P&A Group Flexible Spending Account Claim Form City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees, 2023 |
Download | |
| 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 |
Download | |
| 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 | |
| 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 |
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 |
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 | |
| 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 |