Plan Documents

 
Title Date Sort ascending
2019 Summary of Benefits (SOB) Kaiser Hawaii (Non-Medicare)
City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees, Getting Ready to Retiree, Retirees without Medicare, Superior Court of SF Employees, 2019
March 12, 2019 Download
2019 Summary of Material Modification to the EOC - UHC City Plan PPO
City & County of SF Employees, SF Unified School District Employees, City College of SF Employees, Municipal Executive Employees, Retirees without Medicare, Superior Court of SF Employees, UnitedHealthcare PPO, UHC City Plan PPO, 2019
February 25, 2019 Download
Surrogacy and Adoption Reimbursement Form
City & County of SF Employees, Municipal Executive Employees, Superior Court of SF Employees, 2022, 2021, 2020, 2019
February 14, 2019 Download
2019 Rates for Retirees without Medicare
Retirees, Getting Ready to Retiree, Retirees without Medicare, 2019
January 23, 2019 Download
2019 Rates for Retirees with Medicare
Retirees, Getting Ready to Retiree, Retirees with Medicare, 2019
January 23, 2019 Download
2019 Delta Dental PPO SmileWay Flyer for Retirees
City & County of SF Employees, Municipal Executive Employees, Retirees, Getting Ready to Retiree, Retirees with Medicare, Retirees without Medicare, Superior Court of SF Employees, 2019
January 10, 2019 Download
2019 Delta Dental PPO SmileWay Flyer for Active Employees
City & County of SF Employees, Municipal Executive Employees, Retirees, Getting Ready to Retiree, Retirees with Medicare, Retirees without Medicare, Superior Court of SF Employees, 2019
January 10, 2019 Download
2019 Domestic Partner Declaration Form
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, 2019
January 3, 2019 Download