Plan Documents
| Title | Date Sort ascending | |
|---|---|---|
| 2023 SFHSS Trio 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, Trio HMO, 2023 |
Download | |
| 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, 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 | |
| 2025 Commissioner Health Benefits Enrollment Application Fillable Form City & County of SF Employees, Health Net CanopyCare HMO, Blue Shield of California, Access+ HMO, Trio HMO, Blue Shield of California PPO, Kaiser Permanente HMO, VSP Vision, 2025 |
Download |