Employee Resources

Employee FAQ

Employer Payments

How do I know whether my Employer made payments to the City Option for me?

Your Employer should have sent a Health Care Payment Confirmation Notice to you after the first payment
on your behalf. Our program also sends information to you by mail within 1-3 weeks of your Employer’s first payment.

If you have questions about whether your Employer has made a payment to the City Option Program, please contact your Employer or our Customer Service team at (415) 615-5720.

My Employer made a payment to City Option for me. What program am I eligible for?

Complete an SF City Option Program Finder Form to find out what program you might be eligible for.

You might be eligible for one of three SF City Option health care programs:
     •  If you live outside of San Francisco, under 18, or have health insurance through an employer, spouse,
         parent, Medi-Cal or Medicare, you might be eligible for SF Medical Reimbursement Account (SF MRA).
         Funds in an SF MRA may be used for eligible health care expenses, including out-of-pocket costs
         related to medical, dental, and vision care products and services.
     •  If you live in San Francisco, are required by law to have health insurance, and purchase health insurance
         through Covered California, you might be eligible for SF Covered MRA.
         Funds in an SF Covered MRA may be used to help pay for Covered California health insurance
         premiums and other eligible health care expenses.
     •  If you are uninsured, not eligible for Medi-Cal or Medicare, and live in San Francisco, you might be
         eligible to enroll in Healthy San Francisco and receive a discount on Healthy San Francisco
         participation fees.

Healthy San Francisco (HSF) for Employees

What is Healthy San Francisco?

Healthy San Francisco is a health care access program designed to make health care services available and affordable to uninsured San Francisco residents. Healthy San Francisco participants access primary and preventive care from their Medical Home and primary care physician. The program also provides access to specialty care, urgent and emergency care, laboratory services, inpatient hospitalization, radiology, and pharmaceuticals. For more information about Healthy San Francisco, including services covered and the provider network, please visit www.healthysanfrancisco.org.

Am I eligible to participate in Healthy San Francisco?

You may qualify for Healthy San Francisco if you meet all of the following requirements:
        •  San Francisco resident;
        •  Uninsured for at least 90 days;
        •  Age 18 or over; and
        • Not eligible for public insurance programs, such as Medi-Cal or Medicare.

How do I enroll in Healthy San Francisco?

Click here  for information on how to enroll in Healthy San Francisco.

When does my Healthy San Francisco coverage begin?

Your health care coverage under Healthy San Francisco does not immediately begin upon your Employer’s first payment on your behalf to SF City Option. We will first need to confirm that you qualify for Healthy San Francisco. Within 1-3 weeks of your Employer’s first payment on your behalf, you’ll receive a welcome letter from SF City Option with instructions on how to complete the SF City Option Program Finder Form.
After you send SF City Option your completed form online or by mail, you’ll receive instructions on how to enroll in Healthy San Francisco if SF City Option confirms that you might be eligible for the program. If you qualify for and enroll in Healthy San Francisco, coverage begins on the date of your enrollment appointment.

How much will Healthy San Francisco cost me?

Depending on your household size and income, you may be required to pay a Healthy San Francisco participant fee four times per year if you are eligible for and enroll in the program. Participant fees are based on family income level. The funds your Employer makes on your behalf may be applied towards a discount on your Healthy San Francisco quarterly participant fees.  In addition to the participant fees, you may pay a Point of Service Fee when you receive health care services. For example, an additional fee may be paid each time you visit a physician or emergency room, or pick up a prescription.  The amount of the Point of Service Fee depends on your Medical Home and family income.

What services are included in Healthy San Francisco?

Healthy San Francisco participants access primary and preventive care from their Medical Home and primary care physician. The program also provides access to specialty care, urgent and emergency care, laboratory services, inpatient hospitalization, radiology, and pharmaceuticals. For more information about Healthy San Francisco, including services covered and the provider network, please visit www.healthysanfrancisco.org.

How do I update my address or phone number?

Please call Customer Service at (415) 615-5720.

Who do I contact with questions about Healthy San Francisco?

Our Customer Service representatives are available Monday through Friday from 8:30am to 5:30pm to answer your specific questions about Healthy San Francisco. Please call us at (415) 615-5720 or email us at info@nullsfcityoption.org. If you are deaf, hard-of-hearing, or have speech disabilities you may call us on our TDD/TTY line at (415) 547-7830.

SF Medical Reimbursement Account (SF MRA) for Employees

WHAT IS AN SF MEDICAL REIMBURSEMENT ACCOUNT (SF MRA)?

Funds in an SF Medical Reimbursement Account (SF MRA) can be used for eligible health care expenses incurred by you, your spouse or domestic partner, and your dependents. Some of the many health care expenses eligible for reimbursement are health insurance premiums, doctor office visits, dental services, vision services, and prescription and over-the-counter medicines.

You may qualify for SF MRA if:
        •  Your Employer made contributions to the SF City Option on your behalf; and
        •  If the Employee meets ONE OR MORE of the following requirements:
                   •  Live outside of San Francisco; and/or
                   •  Have health insurance from an employer, spouse, parent, Medi-Cal, or Medicare; and/or
                   •  Are under age 18.

You can submit receipts for eligible expenses and SF MRA claim forms online at mymra.adp.com or by mail, fax, or mobile app and get reimbursed by check or direct deposit with funds from the SF MRA. Learn how to submit claims for reimbursement.

You can still use your SF MRA after you no longer work for the Employer who made the deposits. SF MRA funds are available to spend as long as your account is active. Keep your account active by filing at least one SF MRA claim every 24 months. Our program will close the SF MRA and you will not be able to spend the SF MRA funds if there have been no claims or deposits in over 24 months.

If your SF MRA is closed and you want it re-opened, call 1(415) 615-5720 and we’ll add the SF MRA funds back.

There is a $2.75 administrative fee subtracted from your MRA each month, whether or not you use your SF MRA that month.

Only health care expenses incurred on or after the effective date of your SF MRA are eligible for reimbursement. Your SF MRA effective date is the payment clearance date of the first SF MRA payment from your Employer into your SF MRA.

Can I use my SF MRA to get reimbursed for health insurance premiums?

Yes, health insurance premiums, co-payments, and deductibles are among the many health care expenses eligible for reimbursement from SF MRAs.

AM I ELIGIBLE TO ENROLL IN SF MRA?

You may qualify for SF MRA if you meet OR MORE of the following requirements:
        •  Live outside of San Francisco; and/or
        •  Have health insurance from an employer, spouse, parent, Medi-Cal, or Medicare; and/or
        •  Are under age 18.

HOW DO I ENROLL IN SF MRA?

Click here for information on how to enroll in SF MRA.

Do I have an SF MRA?

Call MRA Customer Service at (866) 697-6078 to see whether you have an SF MRA.

How far back can I submit a claim for reimbursement?

Only health care expenses incurred on or after the effective date of your SF MRA are eligible for reimbursement. Your SF MRA effective date is the payment clearance date of the first SF MRA payment from your Employer into your SF MRA.

HOW MUCH WILL AN SF MRA COST ME?

There is a $2.75 administrative fee subtracted from the available funds in each SF MRA monthly, whether or not you use the account that month. Administrative fees will not be subtracted from the account if the available balance is less than $2.75.

How do I set up a Medical Reimbursement Account?

Click here for information on how to access your SF MRA.

How do I submit a claim?

You may submit receipts and claim forms online or by mail, fax, or mobile app and get reimbursed by check or direct deposit.  For detailed information, please visit the Submit a Claim page.

What expenses are eligible for reimbursement?

Click here to view a detailed list of health care expenses eligible for reimbursement under the SF MRA. Doctor’s office visits, copays, health insurance premiums, eyeglasses and contact lenses, and prescription and over-the-counter medicines are among the many expenses eligible for reimbursement.

How long does it take for me to be reimbursed for eligible health care expenses?

Claims are usually processed within 3 to 5 business days.

Can I submit a claim larger than the available funds in my SF MRA?

If you submit a claim that is greater than the balance of your account, the claim is paid up to the available balance.

Is there a minimum claim amount?

No, you may submit a claim for as little as $0.01 and can still get reimbursed by check or direct deposit for the claim.

Is there a minimum amount for a reimbursement check or direct deposit?

No, you may be reimbursed by check or direct deposit for as little as $0.01.

My Employer made a deposit. When will I see the funds in my SF MRA?

Funds will be available in your SF MRA 1-3 weeks after each employer payment to our program.

HOW LONG WILL MY SF MRA BE AVAILABLE?

You can still use your SF MRA after you no longer work for the Employer who made the deposits. SF MRA funds are available to spend as long as your account is active. Keep your account active by filing at least one SF MRA claim every 24 months. Our program will close the SF MRA and you will not be able to spend the SF MRA funds if there have been no claims or deposits in over 24 months.

If your SF MRA is closed and you want it re-opened, call 1(415) 615-5720 and we’ll add the SF MRA funds back.

Can I still use my SF MRA even after I no longer work for my Employer?

You may continue to use your SF MRA to submit claims for reimbursement even after you no longer work for the Employer.

What is my SF MRA Account balance?

Please call SF MRA Customer Service at (866) 697-6078 for your account balance. You may also check your account balance online at mymra.adp.com.

How do I check the status of my claim?

Please call SF MRA Customer Service at (866) 697-6078 to check on the status of your claim. You may also check the status of claims at mymra.adp.com.

How do I update my address or phone number?

Please call SF MRA Customer Service at (866) 697-6078.

Who do I contact if I have questions about my SF MRA Account?

SF MRA Customer Service representatives are available Monday through Friday from 5:00am PST to 5:00pm PST to answer your specific questions about Medical Reimbursement Accounts. Please call SF MRA Customer Service at (866) 697-6078.

SF Covered Medical Reimbursement Account (SF Covered MRA) for Employees

WHAT IS AN SF COVERED MEDICAL REIMBURSEMENT ACCOUNT (SF COVERED MRA)?

Funds in an SF Covered Medical Reimbursement Account (SF MRA) can be used to pay for Covered California health insurance premiums and co-pays, as well as eligible health care expenses incurred by you, your spouse or domestic partner, and your dependents. Some of the many other health care expenses eligible for reimbursement are dental services, vision services, and prescription and over-the-counter medicines.

You may qualify for SF Covered MRA if your Employer made a contribution to the SF City Option on your behalf and you meet ALL of the following requirements:
        •  San Francisco resident;
        •  Age 18 or over;
        •  Income at or below 500% of the Federal Poverty Level;
        •  Required by law to have health insurance; and
        •  Purchased health insurance through Covered California

The amount deposited into an SF Covered MRA is intended to cover part of your Covered California health insurance premiums and other insurance costs such as copays and deductibles. SF City Option calculates the amount based on these factors:
        •  Income;
        •  Age; and
        •  Start date of the Employee’s Covered California health insurance plan year

You can submit receipts for eligible expenses and claim forms online at mymra.adp.com or by mail, fax, or mobile app and get reimbursed by check or direct deposit with funds from the SF Covered MRA.

You can still use your SF Covered MRA after you no longer work for the Employer who made the payments to SF City Option. You can use your SF Covered MRA to get reimbursed for eligible health care services received or health care items purchased during your Covered California plan year.  All claims must be submitted by March 31 of the next calendar year. After March 31 of the next calendar year, the SF Covered MRA funds will no longer be available for you to spend.

You do not have to pay any fees for having an SF Covered MRA.

You can get reimbursed for eligible health care services received or health care items purchased within your SF Covered MRA plan year. The dates you are covered by your Covered California health insurance plan is your SF Covered MRA plan year. Generally, the plan year is January 1 to December 31. If you purchased health insurance through Covered California after January 1 or during a special enrollment period, the plan year might start after January 1.

AM I ELIGIBLE TO ENROLL IN SF COVERED MRA?

You may qualify for SF Covered MRA if your Employer made a contribution to the SF City Option on your behalf and you meet ALL of the following requirements:
        •  San Francisco resident;
        •  Age 18 or over;
        •  Income at or below 500% of the Federal Poverty Level;
        •  Required by law to have health insurance; and
        •  Purchased health insurance through Covered California

HOW DO I ENROLL IN SF COVERED MRA?

Click here for information on how to enroll in SF Covered MRA.

CAN I USE MY SF COVERED MRA TO GET REIMBURSED FOR HEALTH INSURANCE PREMIUMS?

Yes, health insurance premiums are eligible for reimbursement from an SF Covered MRA.

DO I HAVE AN SF COVERED MRA?

Contact your Employer or call MRA Customer Service at (866) 697-6078 to confirm whether employer payments into an MRA have been made on your behalf.

HOW FAR BACK CAN I SUBMIT A CLAIM FOR REIMBURSEMENT?

You can get reimbursed for eligible health care services received or health care items purchased within your SF Covered MRA plan year. The dates you are covered by your Covered California health insurance plan is your SF Covered MRA plan year. If you need to find out your SF Covered MRA plan year, call Customer Service at (866) 697-6078.

HOW LONG WILL MY SF COVERED MRA BE AVAILABLE?

To get reimbursed for eligible health care services received or health care items purchased during the plan year, you must submit your MRA claims by March 31 of the next calendar year. After March 31 of the next calendar year, the SF Covered MRA funds will no longer be available for you to spend.

CAN I STILL USE MY SF COVERED MRA EVEN AFTER I NO LONGER WORK FOR MY EMPLOYER?

Yes, you can still use the funds in your SF Covered MRA after you no longer work for the employer who made the payments to SF City Option.

CAN I CASH OUT MY SF COVERED MRA?

No, you can only spend SF Covered MRA funds by sending claims for reimbursement of eligible health care expenses.

HOW MUCH WILL AN SF COVERED MRA COST ME?

There are no fees for having a SF Covered MRA.

HOW DO I SUBMIT A CLAIM?

To get reimbursed for eligible health care expenses, you first need to pay for the expenses and make sure to get a receipt. You can then file an SF Covered MRA claim and get reimbursed for approved expenses from the funds in your SF Covered MRA. You may submit receipts and claim forms online or by mail, fax, or mobile app and get reimbursed by check or direct deposit.  For detailed information, please visit the Submit a Claim page.

WHAT EXPENSES ARE ELIGIBLE FOR REIMBURSEMENT?

Click here to view a detailed list of health care expenses eligible for reimbursement under the SF Covered MRA. Doctor’s office visits, copays, health insurance premiums, eyeglasses and contact lenses, and prescription and over-the-counter medicines are among the many expenses eligible for reimbursement.

HOW LONG DOES IT TAKE FOR ME TO BE REIMBURSED FOR ELIGIBLE HEALTH CARE EXPENSES?

Claims are usually processed within 3 to 5 business days.

CAN I SUBMIT A CLAIM LARGER THAN THE AVAILABLE FUNDS IN MY MRA?

Yes, you can send a claim greater than the balance of your SF Covered MRA. If you have funds available in another MRA, funds will also be withdrawn from the other MRA. If you do not have another MRA with funds available, the claim is paid up to the available account balance.

IS THERE A MINIMUM CLAIM AMOUNT?

No, you can send a claim for as little as $0.01 and get reimbursed if the claim is approved.

IS THERE A MINIMUM AMOUNT FOR A REIMBURSEMENT CHECK OR DIRECT DEPOSIT?

No, you can get reimbursed by check or direct deposit for as little as $0.01.

HOW WAS MY SF COVERED MRA DEPOSIT AMOUNT CALCULATED?

Our program calculated the amount based on your income, your age, the start date of your Covered California health insurance plan year, and the cost of the second-lowest Covered California Silver plan in San Francisco for a household size of 1.

WHAT IS MY CURRENT SF COVERED MRA ACCOUNT BALANCE?

Call Customer Service at 1(866) 697-6078. You can also check your account balance online at mymra.adp.com.

WHAT IS MY SF COVERED MRA ACCOUNT NUMBER?

Your account number is a unique number set up by the SF City Option.

DO I HAVE TO SIGN UP FOR SF COVERED MRA AGAIN NEXT YEAR?

If you want to have a SF Covered MRA next year, you will need to apply again. SF City Option will need to confirm that you still qualify for the program and calculate the amount of your new deposit.

WHAT IS THE DIFFERENCE BETWEEN A SF COVERED MRA AND THE OTHER MRA PROGRAM?

SF Covered MRA is a program that helps make health insurance more affordable for eligible San Francisco residents who purchase health insurance through Covered California. The amount deposited into a SF Covered MRA is intended to cover part of your health insurance premiums and other health insurance costs. The other MRA program (SF MRA) is available to those who don’t qualify for SF Covered MRA.

CAN I HAVE AN SF COVERED MRA AND AN SF MRA AT THE SAME TIME?

Yes, if you previously had an SF MRA, those funds will still be available to you for reimbursement of eligible health care expenses. You should submit your claims through your SF Covered MRA first because the funds will expire at the end of the SF Covered MRA plan year.

HOW DO I CHECK THE STATUS OF MY CLAIM?

Call Customer Service at 1(866) 697-6078. You can also check on your claims online at mymra.adp.com.

HOW DO I UPDATE MY ADDRESS OR PHONE NUMBER?

Call Customer Service at 1(866) 697-6078.