This document provides an overview of benefits available to new employees of the City and County of San Francisco from January to December 2016. It summarizes the health, dental, vision, flexible spending accounts, life insurance, and other benefits administered by the Health Service System. It instructs new employees to enroll within 30 days, outlines their plan and coverage options, and provides contact information for the Health Service System.

1. New Employee Orientation January–December 2016

2. New Employee Orientation January–December 2016
Welcome.
Congratulations on your new job!

3. New Employee Orientation January–December 2016
Health Service System (HSS) Overview
• HSS administers City & County of San Francisco employee
health benefits.
- Medical - Flexible Spending Accounts (FSAs)
- Vision - Long Term Disability (LTD) Insurance
- Dental - Group Life Insurance
- Employee Assistance Program (EAP)
- Wellness
• Health benefits plan year is January 1 through December 31.
• You must enroll within 30 days of your start work date
to receive health benefits. Your enrollment is not automatic.

4. New Employee Orientation January–December 2016
How Do I Choose a Medical Plan?
Here are considerations to keep in mind when
choosing a health plan:
Cost – how much will I pay?
Choice of doctor, medical group and hospital
Convenience / access to care
Personal situations (medical needs, balancing
coverage if your partner has a plan, etc.)

5. New Employee Orientation January–December 2016
Medical Plan Premium Contributions
• Employee premium contributions vary based on:
- Employer contribution
- Medical / dental plan elected
- Union
- Number of covered dependents
- Employee only
- Employee + 1 dependent
- Employee + 2 or more dependents
• To review your premium contribution rates,
read your Benefits Guide or visit myhss.org.

6. New Employee Orientation January–December 2016
HMO
Kaiser
HMO
Blue Shield
PPO
City Plan
Primary Care
Provider yes yes no
Deductible $0 $0
$250 member only
$500 + 1, $750 + 2
Office Visit
$0 - preventive
$20 - other
$0 - preventive
$25 - other
100% preventive
85% in-network
50% out-of-network
Service Area Kaiser facilities,
ER
Blue Shield
network, ER
PPO and out-of-
network, worldwide
Information on this chart is effective January–December 2016.
Medical Plan Options

7. New Employee Orientation January–December 2016
VSP Vision Plan
• Vision benefits are only available when medical plan is
elected.
• No additional premium contributions required
for the vision plan.
• No ID card issued. Make appointment with VSP doctor who
gets authorization from VSP.
• VSP network benefits
- vision exam every 12 months, co-pay $10
- frames/lenses/contacts every 24 months, co-pay $25
- frames/contacts covered to $150
- urgent eye care $5 co-pay
• Claims reimbursed from non-VSP providers.

8. New Employee Orientation January–December 2016
2016 Dental Plan Options
PPO
Delta Dental*
HMO
DeltaCare USA
HMO
UnitedHealthcare
Dental Offices in SF more than 500 14 32
Primary Care
Dentist no yes yes
Authorization to
Specialist
no yes yes
Service Area outside of area must live in
DHMO area
must live in
DHMO area
Waiting Period some exceptions* none none
*6-month waiting period for dentures, pontics, bridges, orthodontia and implants.

9. New Employee Orientation January–December 2016
2016 Dental Plan Options
PPO
Delta Dental*
HMO
DeltaCare USA
HMO
UnitedHealthcare
Cleaning and Exam
100% / 2x/yr
3x/yr pregnant
100% / 6 months 100% every 6 months
Fillings 80% 100% 100%
Orthodontia
50%;
$2000 max child
$350 start fee; $1500
max child
$350 start fee;
$1660 max child
Crowns 80% 100% 100%
*Delta Dental cost shares shown are for PPO/Premiere/out-of-network dentists.

10. New Employee Orientation January–December 2016
Flexible Spending Accounts (FSAs)
• Optional; you must re-enroll every plan year.
• Saves money by reducing income taxes.
• Allows you to pay for eligible medical, dental and
dependent care expenses on a pre-tax basis.
• Contributions you make are deducted from your pay
BEFORE Federal, State or Social Security taxes are
calculated.
• For list of eligible expenses, visit padmin.com.

11. New Employee Orientation January–December 2016
FSAs: Types & Examples
• Healthcare FSA
- co-pays (office visits, pharmacy)
- eyeglasses
- orthodontic treatment
- weight loss programs (doctor’s order)
- over-the-counter medications
(only with prescription)
• Dependent Care FSA
- licensed facilities only
- day care services
- summer day camp

12. New Employee Orientation January–December 2016
FSAs: Things to Consider
• How much do you want to contribute in 2016?
- minimum $250
- maximum $2,500 for Healthcare FSA
- maximum $5,000 for Dependent Care FSA
• For reimbursement, submit receipts and
documentation to FSA administrator P&A Group.
• Enroll as a new employee or annually during
Open Enrollment.
• Healthcare FSA only: total annual contribution is available on
day one of the plan year.
• Healthcare FSA only: up to $500 in unused contri-butions will
automatically carryover to next plan year.

13. New Employee Orientation January–December 2016
Long Term Disability (LTD) Plan
• Many union contracts provide for employer-paid LTD
insurance. If this benefit is available to you, the flyer is in
your packet.
- eligibility and definition of disability
- beginning and end of coverage
• Financial protection by paying a significant percentage of
your income while you are disabled.
• Maximum benefit $5,000 per month.
• Waiting period 3 to 6 months depending on union.
• Administered by Aetna.
• No coverage if LOA due to non-medical reasons.

14. New Employee Orientation January–December 2016
Group Life Insurance Plan
• MEA, MAA, SEIU 1021, Teamsters 856, TWU 200,
IFPTE Local 21
• Amount varies by union
• Eligibility
- permanent: 1st
of the month following start date
• - provisional: 1,040 hours in a 6-month period
• Beneficiary
- recipient of proceeds to be paid at your death
- you may name more than one beneficiary
- if you don’t name a beneficiary proceeds go to
spouse or domestic partner, natural or adopted
children, parents or your estate – in this order.

15. New Employee Orientation January–December 2016
Employee Assistance Program (EAP)
• Short-term therapy and counseling.
• No cost (free) to all City employees and their family members.
• Staffed by state certified, licensed therapists.
• Confidential and voluntary.
• Appointments available 9:00am to 4:00pm, Monday–Friday.
• To schedule an HSS EAP appointment call
1-800-795-2351.

16. New Employee Orientation January–December 2016
Employee Wellness
• Lunchtime fitness classes and workshops throughout the
City. Class calendar online at myhss.org.
• Employee wellness center at 1145 Market Street, 1st
Floor.
• Fitness club/gym discounts.
• Health plans also offer wellness benefits.
• Individual departments may also offer other
wellness programs.

17. New Employee Orientation January–December 2016
Benefits Enrollment Process
• Only three opportunities to enroll or make changes:
1. Within 30 days of start work date as a new employee
2. Within 30 days of a Qualifying Event (change in status)
3. During annual Open Enrollment
• Dependent documentation (copy of marriage certificate,
birth certificate, etc.) must be submitted with signed
enrollment form.
• If you miss the 30 day deadline, no enrollment change
allowed until Open Enrollment.

18. New Employee Orientation January–December 2016
New Hire Coverage Effective Date
• Coverage will begin the first day of the coverage period after
a complete enrollment application is filed with HSS.
• A complete application includes all dependent documentation
and your signed enrollment form.
• To verify the exact date your coverage will begin, contact the
Health Service System.

19. New Employee Orientation January–December 2016
Eligible Dependents
• Legal Spouse or Domestic Partner.
• Children from birth up to age 26 (natural child, adopted
child, stepchild, domestic partner’s child).
• Children up to age 19 (legal guardianship,
court order).
• PROOF: Copy of certificate of marriage or domestic
partnership, birth certificate, adoption paperwork, court or
guardianship order.
• No dual eligibility for employees or dependents enrolled
in HSS medical, dental or vision plans.

20. New Employee Orientation January–December 2016
Ineligible Dependents
• HSS routinely audits enrollment.
• You must notify HSS once your dependents are
no longer eligible to be covered on your plan.
• Ineligible dependents:
- Divorced spouse and associated step-children
- Former domestic partner after legal dissolution
of partnership
- Legally separated spouse
- Court ordered or guardianship children at age 19
- Natural, step, and adopted children at age 26

21. New Employee Orientation January–December 2016
Qualifying Events
A qualifying event is a family status change, or other change
in status, that allows you to change enrollment choices
outside of Open Enrollment.
Qualifying events include:
-marriage or legal domestic partnership
-birth, adoption, or legal guardianship
of a child
-divorce, legal separation or dissolution of
partnership
-loss or obtaining other coverage
-moving outside of a plan’s service area
-death of dependent or member

22. New Employee Orientation January–December 2016
Qualifying Events
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
DEADLINEDAY OF EVENT
If there is a qualifying event, you may change some
health benefits within 30 calendar days of the event.
If you miss the 30-day deadline you must wait until
the next Open Enrollment.
Don’t wait. Call HSS at 1-415-554-1750 if you have
questions about a qualifying event and changing your
enrollment choices.
1 30

23. New Employee Orientation January–December 2016
Open Enrollment
• Next Open Enrollment takes place in October 2016 for
the 2017 January through December plan year
• During Open Enrollment you may:
- keep or change your benefit elections
- add or drop eligible dependents
- enroll or re-enroll in a Flexible Spending Account
• HSS mails Open Enrollment information. Make sure HSS
has your current address!

24. New Employee Orientation January–December 2016
Unpaid Leave of Absence
• You must notify HSS before, or soon after, you go on leave.
• For all types of unpaid leave, payment must be made to HSS
each month you are on leave, for the premium amount due.
• If you do not notify HSS before going on approved leave, or
you do not make required payments to HSS while on leave,
your benefits may be terminated.
• You must notify HSS when you return to your job after your
leave ends so payroll deductions for health benefits can
resume.

25. New Employee Orientation January–December 2016
Unpaid Leave of Absence and FSAs
• If you do not receive a paycheck for any pay period due
to unpaid leave, and deductions are not taken to fund an
FSA, it will be cancelled.
• Dependent Care FSA must be suspended while you are
on leave, and claims incurred during leave are not
reimbursable.

26. New Employee Orientation January–December 2016
Stay In Touch and Informed
About Your Benefits
• Always keep your address current with your employer and HSS.
• Rates and benefits change every year.
• Visit myhss.org often for benefits updates.
• Register online for monthly email news.
• Make sure HSS has your correct residential and mailing address.
Contact HSS if you have a change of either address.
• Call or visit HSS Member Services if you have questions
about your benefits: 1-415-554-1750.

27. New Employee Orientation January–December 2016
myhss.org

28. New Employee Orientation January–December 2016
PHONE:
1-415-554-1750
IN PERSON:
1145 Market Street 3rd
Floor
San Francisco, CA
PHONE AND OFFICE HOURS:
Monday through Friday
8:00am to 5:00pm
(Open at 9:30 am every other Thursday)
WEBSITE:
myhss.org
Questions? Contact HSS.