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, 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, UHC PPO (pre 2022), UHC Medicare Advantage PPO, VSP Vision, 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, 2020 |
Download | |
| HIPAA Authorization for Use and Disclosure of Protected Health Information City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Superior Court of SF Employees, 2020 |
Download | |
| HIPAA Request Accounting of Disclosures City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Superior Court of SF Employees, 2020 |
Download | |
| HIPAA Request for Amendment to Health Information City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Superior Court of SF Employees, 2020 |
Download | |
| 2019 Form HIPAA Request for Confidential Communications 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, 2018 |
Download | |
| HIPAA Request Restrictions City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Superior Court of SF Employees, 2020 |
Download | |
| HIPAA Request to Inspect Information City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Superior Court of SF Employees, 2020 |
Download |