Employees of the City & County of San Francisco - take good care of your benefits and your benefits will take care of you. Here are a few things you should know.

1. April 2015
6 Things Every Employee Should
Know About Health Benefits
FOR ACTIVE EMPLOYEES OF THE
CITY & COUNTY OF SAN FRANCISCO

2. April 2015
Benefits are complex.
News can be confusing.
If you are a City & County of
San Francisco employee,
the Health Service System
is your trusted resource
for health benefits
information.
Your Trusted Resource for Health Benefits Information

3. April 2015
Health Service System (HSS)
HSS administers employee health and wellness benefits for the
City & County of San Francisco .
HEALTH
- Medical - Flexible Spending Accounts (FSAs)
- Dental - Long Term Disability (most unions)
- Vision - Group Life Insurance (some unions)
WELLNESS
- Employee Assistance Program (EAP)
- Wellness Center Classes and Workshops
- Health Club Discounts
- Shape Up Walking Challenge
- Well-being Assessment
Your Trusted Resource for Health Benefits Information

4. April 2015
Health Service System (HSS)
PHONE:
(415) 554-1750
IN PERSON:
1145 Market Street 3rd
Floor
San Francisco, CA
No appointment needed.
First come first serve.
HOURS:
Monday through Friday
8:00am to 5:00pm
(Open at 9:30 am
every other Thursday)
Your Trusted Resource for Health Benefits Information

5. April 2015
myhss.org
• A lot of what you need to
know about employee
health benefits is online.
• Health plan documents
and enrollment forms.
• Wellness program
information.
• Member rules.
• Health Service Board
meetings.
Health Service System (HSS)
Your Trusted Resource for Health Benefits Information

6. April 2015
Take good care of your benefits and
your benefits will take good care of you!
Remember these six things.
Your Trusted Resource for Health Benefits Information

7. April 2015
New hire
New spouse
New domestic partner
Loss of other coverage
New baby
Newly adopted child
New stepchild
If you miss the 30-day deadline you must wait
until October Open Enrollment to enroll, with
coverage beginning in January.
6 Things Every Employee Should Know About Health Benefits
For example:
1 There is a 30 day deadline to enroll.

8. April 2015
2 To enroll, you must provide
eligibility documentation.
Proof of hire
Marriage certificate
Domestic partner
certificate
Birth certificate
Adoption certificate
Court order
Social Security number
Copies please. No original documents.
6 Things Every Employee Should Know About Health Benefits
For example:

9. April 2015
Ex-husband or ex-wife
Ex-domestic partner
Step-children from former
marriage or partnership
Children who age out
of eligibility
Don’t risk paying significant penalties for
coverage of ineligible dependents.
6 Things Every Employee Should Know About Health Benefits
3 You must disenroll family
members who become ineligible.
For example:

10. April 2015
You must
contact HSS
at the start
of a leave of
absence.
Going on a leave can affect all your health benefits.
You may need to pay premium contributions to
HSS. Don’t risk termination of benefits while on
leave. Call HSS at 415-554-1750.
– and –
You must
contact HSS
when you
return to work
after a leave.
6 Things Every Employee Should Know About Health Benefits
4

11. April 2015
You may need to enroll in a different plan
based on your new address, based on plan
service areas.
6 Things Every Employee Should Know About Health Benefits
5 If you move to a new address
you must contact HSS.
Don’t risk termination of your health benefits
due to a move. Call HSS at 415-554-1750.

12. April 2015
When you retire you must visit the Health
Service System to learn about, and enroll in,
retiree health benefits. You are not automatically
enrolled in retiree benefits.
6 Things Every Employee Should Know About Health Benefits
6 Retiree health benefits are different
from employee benefits.
Don’t risk a break in coverage when you are
no longer eligible for active employee benefits.

13. April 20156 Things Every Employee Should Know About Health Benefits
Employees Hired On or After January 10, 2009: Prop B 2008 Charter Amendment
Retiree Benefits Eligibility
• At least five years of service with the City, Unified School District and/or City College.
No reciprocity with other government employers. HSS calculates service.
- and -
• Must retire within 180 days of separation from active service.
Health Insurance Premium Contribution for Eligible Retirees
5 to <10 years of service: retiree pays 100% of premium.
10 to <15 years of service: employer pays 50% of premium; retiree pays 50%.
15 to <20 years of service: employer pays 75% of premium; retiree pays 25%.
>20 years of service: employer pays 100% of premium; retiree pays 0%.
6 Retiree health benefits are different
from employee benefits.

14. April 2015
2015 Medical: City & County Employees
Kaiser HMO Blue Shield HMO City Health Plan PPO
Deductible $0 $0 $250 per enrollee
Doctor Visit $20 copay $25 copay
85% co-insurance In-Network
50% co-insurance Out-of-
Network
Out-of-Pocket
Maximum
$1,500 individual
$3,000 family
$2,000 individual
$4,000 family
$3,750 per person (In-Network)
$7,500 per person (Out-of-
Network)
Network
Kaiser only
except
emergencies.
Blue Shield network
only except
emergencies.
You can obtain service from
any provider but out-of-network
costs more.
HSS Health Plans

15. April 2015
2015 Dental: City & County Employees
PPO
Delta Dental*
Dental HMO
DeltaCare USA
Dental HMO
Pacific Union
Bay Area Dental Offices more than 500 14 32
Primary Care Dentist no yes yes
Authorization to Specialist no yes yes
Cleaning & Exam
100% / 6 months
3x/yr pregnant
100% / 6 months 100% / 6 months
Fillings 90%/80% 100% 100%
Orthodontia
50%;
$2500 max child
$350 start fee;
$1600 max child
$350 start fee;
$1600 max child
Waiting Period some exceptions* none none
Service Area outside of area must live in DHMO
area
must live in
DHMO area
*Delta Dental costs shown are for PPO/Premiere/Out-of-Network. Premiere and out-of-network dentist costs are higher.
6-month waiting period for dentures, pontics, bridges, orthodontia and implants.
HSS Health Plans

16. April 2015
2015 Vision: City & County Employees
• VSP vision benefits are only available if you are enrolled in a
medical plan.
• The City pays all premium contributions for the vision
benefit. Employee pays any co-pay costs.
• 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 - urgent eye care $5 co-pay
- frames/lenses/contacts every 24 months, co-pay $25 - frames/contacts covered to $150
- some unions have VDT benefit for computer users
• Claim reimbursement for service from non-VSP providers.
HSS Health Plans

17. April 2015
• Employee Assistance Program (EAP) – short-term therapy
and counseling. No cost. Call (800) 795-2351.
• Employee Wellness Center at 1145 Market Street 1st
Floor.
Classes and workshops during lunch and after work.
• Local fitness club discounts.
• Annual City-wide Well-being Assessment.
• City-wide events like the Shape Up Walking Challenge.
• Wellness champions in all City departments.
• More information email wellness@sfgov.org.
Employee Well-being Benefits
Well-being Benefits

18. April 2015
HSS Is Here For You!
• Rates and benefits change every year!
• Visit myhss.org .
• Register online for monthly eNews.
• Call the Health Service System if you have questions
about your benefits: (415) 554-1750.
• Visit the Health Service System. No appointment is necessary.
1145 Market Street, 3rd
Floor.
Stay Informed