Board Policies and Reference Documents

The Health Service Board Governance Committee revises the Governance Policies and Terms of Reference. The Full Board approved the current document on December 11, 2025. 

A City Charter is like a city’s constitution. It explains how the city government is set up, what powers it has, and the basic rules it follows. The Administrative Code is a set of detailed rules that show how the city runs day to day.

The document includes all the Charter and Administrative Codes the Board must follow. 

This presentation was done in November 2016.

Agenda item: San Francisco City Charter Sections Relevant to the Health Service Board.

The yearly report gives us up-to-date info on the people enrolled in health benefits. This report breaks down info on our members by race, gender, age, employer, home neighborhood, and the health benefits they are enrolled in.

The report shares what SFHSS achieved in the previous year.

California’s top 10 counties share how much they paid spent on employee health benefits. This report provides the average increase in healthcare costs. San Francisco must pay the same amount toward its employee benefits.

Each year, we have something called the Rates and Benefits Cycle. In this process, SFHSS looks at our health plans and decides if any changes are needed, including how much they cost. This helps SFHSS set goals and figure out what we need to do to stick to the SFHSS Mission. The process happens in meetings that everyone can attend, from February to June each year. The calendar shows when all the presentations about health plan rates will be.

There are two Blackout Notices in effect.

The first notice is about the proposal for COBRA, Healthcare Flexible Spending Account (FSA), Dependent Care Spending Account (DCSA) and AB 528 administration and the presentation of the results of this 2026-2027 COBRA, FSA, DCSA & AB 528. This notice tells the Health Service Board about a time when certain rules must be followed. During this time, Board members cannot engage in unauthorized communications or activities related to the with the 2026-2027 COBRA, FSA, DCSA & AB 528 RFP.

THe second notice is about the Active Self-Funded PPO (RFP). This notice tells the Health Service Board about a time when certain rules must be followed. During this time, Board members cannot engage in unauthorized communications or activities related to the Active Self-Funded PPO Dental RFP and the SFHSS Annual Rates and Benefits process.

The strategic plan outlines the top goals for the department. New goals are created every three years. This report tells what work has been done for each goal.

Presentation by Chris Sears from Ice Miller Legal Council at the September 2025 Health Service Board Regular Board meeting. 

Agenda Item: HSB Settlor and Fiduciary Role Training

Video presentation

Presentation by Chris Sears from Ice Miller Legal Council at the January 2024 Health Service Board Regular Board meeting. 

Agenda Item: SFHSS Fiduciary Training

Video presentation

Presentation by Chris Sears from Ice Miller Legal Council at the August 2021 Health Service Board Regular Board meeting. 

Agenda Item: SFHSS Fiduciary Training

Video presentation

Presentation by the San Francisco City Attorney's Office at the November 2015 Health Service Board Regular Board meeting. 

Agenda Item: Fiduciary Responsibilities of the Health Service Board Commission.