Change in Employment Status
If you are notified of a change in your employment status, contact SFHSS to learn about the options available for continuing your healthcare coverage to avoid a disruption in coverage for you and your dependents.
This information offers a general outline and does not include all the information you may need to know. When you receive the notice informing you of your change in employment status there are three steps you should take to learn about your health coverage options:
- Consult with your Department Personnel Officer to make sure you understand your new personnel status.
- Confirm with your Personnel Officer that any changes regarding your employment status have been entered into the City’s PeopleSoft system.
- Call or visit SFHSS Member Services to get information about the coverage options, including rates and payment plans, that are available to you. Payments to SFHSS can be made via credit or debit card by completing an SFHSS Auto-Pay Form.
Employees Changing From Full-Time to Temporary Exempt or Part-Time Status
Employees who change from permanent to temporary exempt status will maintain their medical, dental and vision benefits if they meet the following eligibility requirements:
- Must work a minimum of 20 hours per week or
- Must work 1,040 hours in a rolling 12-month period
SFHSS will continue to deduct employee premium contributions payments from part-time employee paychecks. If a payroll deduction is not sufficient to pay for premium contributions, the employee must contact SFHSS directly and pay premiums to SFHSS on a timely basis, via check, money order, credit or debit card. Missed premium payments will result in termination of coverage.
Employees with Holdover Rights
Employees who are placed on an eligible holdover roster may be eligible to continue medical, dental and vision benefits for themselves and their covered dependents for up to five years, as long as they meet all of the following three requirements:
- Employees must certify that they are unable to obtain healthcare coverage from another source;
- Employees must complete and submit a Certificate of Eligibility Form to SFHSS on an annual basis (contact SFHSS for more information about this); and
- Employees must pay the same amount that was deducted from his/her paycheck prior to lay off (rates are subject to increase each Plan Year).
Employees with No Holdover Rights
Employees who have no holdover rights may be eligible to continue medical, dental and vision coverage under COBRA. The healthcare coverage you had as an active employee will end on the last day of the coverage period in which your employment terminates. For information about COBRA, contact SFHSS' COBRA Administrator P&A Group at (800) 688-2611 or visit padmin.com.
Employees Placed On Leave
City employees may be able to continue healthcare coverage through SFHSS if placed on leave. Certain conditions apply. Read more about continuing healthcare benefits while on a leave of absence.
Former Employees With No Holdover Rights
The Consolidated Omnibus Budget Reconciliation Act (COBRA) enacted in 1986 offers employees and their covered dependents the opportunity to elect a temporary extension of healthcare coverage in certain instances where coverage would otherwise end. Read more about COBRA here.
California residents who are not eligible for SFHSS coverage should consider obtaining health insurance through the state insurance exchange, Covered California. In some cases, you may qualify for tax credits and other assistance to make health insurance more affordable. For information about Covered California health plans, call (888) 975-1142 or visit Covered California. For information about the health insurance exchanges in other states visit healthcare.gov.