僱員常見問題

City Option 程序

如果您以前已加入一項 SF City Option 計劃,但您的情況發生了改變(如,您遷居到 San Francisco 外,或您的保險發生變化),請與我們的 Customer Service 聯絡求助,電話 (415) 615-5720。

僱主付款

您的僱主應當代表您在首次付款後已經發送了醫療保健付款確認通知 給您。 我們的計劃也會在您的僱主第一次付款後的 1 至 3 週內透過郵遞發送資訊給您。

若您對僱主是否向 SF City Option 計劃付款存有疑問,請聯絡您的僱主或我們的客戶服務團隊,電話為:(415) 615-5720。

如果您認為您應獲得某些類型的健康福利(健康保險,City Option 福利等),請與 Labor Standards Enforcement 辦公室聯絡,電話:(415) 554-7892 或發送電子郵件至:HCSO@sfgov.org。

完成一份 SF City Option Program Finder Form 以找出您可能有資格加入的計劃。

您可能有資格加入三個 SF City Option 醫療保健計劃中的一個:

  • 如果您居住在三藩市之外,且不滿 18 歲,或者透過僱主、配偶、父母、Medi-Cal 或 Medicare 而獲得了醫療保險,那麼您可能符合 SF Medical Reimbursement Account (SF MRA) 的資格要求。SF MRA ( ) 中的款項可用於合格的醫療保健開支,包括有關醫療、牙科以及視力護理產品和服務的現金支付費用。
  • 如果您居住在三藩市,依照法律要求擁有醫療保險,且醫療保險透過 Covered California 購買,那麼您符合 SF Covered MRA 的資格要求SF Covered MRA 中的款項可能用於幫助支付 Covered California 醫療保險費和其他合格的醫療保健費用。
  • 如果您沒有醫療保險,不符合 Medi-Cal 或 Medicare 的資格要求,且居住在三藩市,那麼您可能有資格註冊登記 Healthy San Francisco。並享受到 Healthy San Francisco 參與費的折扣。

Healthy San Francisco (HSF) 的僱員相關規定

Healthy San Francisco 計劃是一個旨在為沒有參加保險的三藩市居民提供可負擔之醫療保健服務的醫療保健存取計劃。 Healthy San Francisco 計劃參與者可以享受其醫療診所和初級保健醫生提供的初級和預防保健服務。 該計劃亦提供專科護理、緊急護理、實驗室服務、住院治療、放射學和藥品服務。 欲瞭解 Healthy San Francisco 計劃(包括承保服務和服務提供商網絡)的更多資訊,請瀏覽 www.healthysanfrancisco.org

若您符合以下全部要求,則可能有資格參加 Healthy San Francisco:

  • 三藩市居民;
  • 至少有 90 天未參保;
  • 年滿 18 歲; 及沒有資格參加公共保險計劃,如 Medi-Cal 或 Medicare。

按這裡 以瞭解如何註冊加入 Healthy San Francisco 計劃之資料。

您的 Healthy San Francisco 中的醫療保健承保不會在您的僱主代表您第一次向 SF City Option 付費後立即生效。 我們將首先確認您是否有資格參加 Healthy San Francisco。在您的僱主代表您第一次付費的 1 至 3 週內,您將會收到一封來自 SF City Option 的歡迎信,其中包含了如何完成 SF City Option Program Finder Form的說明。

在您將完成的表格透過線上或郵遞的方式發送給 SF City Option 後,您將會收到如何註冊登記 Healthy San Francisco 的說明,前提是 SF City Option 確認您可能有資格加入計劃。 若您符合資格並註冊登記 Healthy San Francisco 計劃,承保將於您預約註冊登記計劃之日起開始生效。

根據您的家庭規模和收入,如果您合格且註冊該計劃,則您需要每年支付四次 Healthy San Francisco 參保費。參保費的多少基於家庭收入水準。您的雇主代表您支付的資金可用於貼現您的 Healthy San Francisco 季度參保費。除參保費之外,於您接受醫療保健服務時,您可能要支付服務點費用。例如,您每次前往醫生或急診室就診或取得處方時,可能要額外付費。服務點費用金額取決於您指定的醫療之家和家庭收入。

Healthy San Francisco 計劃參與者可以享受其醫療診所和初級保健醫生提供的初級和預防保健服務。 該計劃亦提供專科護理、緊急護理、實驗室服務、住院治療、放射學和藥品服務。 欲瞭解 Healthy San Francisco 計劃 (包括承保服務和服務提供商網絡) 的更多資訊,請瀏覽 www.healthysanfrancisco.org

請致電我們的客戶服務部,電話:(415) 615-5720

我們的客戶服務代表的服務時間為周一至週五上午8:30至下午5:30,以回答您的具體問題 Healthy San Francisco. 請致電我們(415) 615-5720 或發送電子郵件至info@healthysanfrancisco.org.如果你是聾,聽力障礙或有語言障礙,你可以在我們的TDD / TTY線上打電話給我們 (415) 547-7830.

請撥打我們的電話 (415) 615-5720 或發送電子郵件至 info@healthysanfrancisco.org。若您失聰、有聽力障礙或言語殘障,您可撥打我們的 TDD/TTY 熱線電話 (415) 547-7830。

SF Medical Reimbursement Account (SF MRA) 的僱員相關規定

若您符合以下全部要求,您可能有資格擁有 SF MRA :

  • 居住在三藩市外; 和/或
  • 擁有從僱主、配偶、父母、Medi-Cal 或 Medicare 得到的醫療保險; 和/或
  • 未滿 18 歲。

按一下這裡以獲取如何註冊登記 SF MRA 的資訊。

是的,醫療保險費、共付額和自付額是眾多可由 SF MRA 償付的醫療保健費用中的一部分。

SF Medical Reimbursement Account (SF MRA) – 中的款項能夠用於支付合格醫療保健費用,您、您的配偶或家庭伴侶以及您的家屬所產生的合格醫療保健費用。 眾多合格的醫療保健費用償付包括醫療保險費、醫生辦公室看診、牙科服務、視力服務以及處方和非處方藥。

您可能有資格擁有 SF MRA – ,前提是:

  • 您的僱主代表您向 SF City Option – 付費; 及
  • 您滿足以下一個或多個要求:
    • 搬離三藩市; 和/或
    • 擁有從僱主、配偶、父母、Medi-Cal 或 Medicare 得到的醫療保險;和/或
    • 未滿 18 歲。

您能夠線上提交合格費用的發票和 SF MRA 償付表格 (網址 mymra.wageworks.com),或者透過郵遞、傳真或移動手機應用程式用支票或直接存款 SF MRA – 獲得償付。 瞭解如何提交償付申請

您不再為繳納 SF MRA –( ) 存款的僱主工作之後,仍可以使用他們賬戶中的資金。 只要賬戶處於活躍狀態,您就可以使用 SF MRA 款項。 您可以每 24 個月至少提出一次 SF MRA 償付申請使賬戶處於活躍狀態。 如果在連續超過 24 個月內沒有提出請求或存入存款,我們的計劃將關閉該 SF MRA ,您將無法再使用 SF MRA 款項。

如果您的 SF MRA 已經被關閉而您希望將其重新開啟,請致電 1(415) 615-5720,同時我們會返還 SF MRA 資金。

每個月會從您的 MRA 扣除 2.75 美元管理費,不管您在當月是否使用了 SF MRA。

只有在 SF MRA 生效日期當天或之後產生的醫療保健費用能夠被償付。 您的 SF MRA 生效日期是您的僱主第一次向您的 SF MRA 付款,並將款項存入 SF MRA 的付款清算日期。

是的,醫療保險費、共付額和自付額是多種 SF MRA 合格醫療保健費用報銷中的一部分。

只有在 SF MRA 生效日期當天或之後產生的醫療保健費用能夠被償付。 您的 SF MRA 生效日期是您的僱主第一次向您的 SF MRA 付款,並將款項存入 SF MRA 的付款清算日期。

撥打 MRA 客戶服務電話 (866) 697-6078 以獲知您是否擁有 SF MRA。

每月會從每個 SF MRA 扣除 2.75 美元的行政管理費用,不論您當月是否使用該賬戶。 如果賬戶餘額低於 2.75 美元,我們不會從賬戶中扣除行政管理費。

按一下這裡以獲取如何存取您的 SF MRA 的資訊。

您可以透過線上、郵遞、傳真或移動應用程式方式提交收據和償付申請,並以支票或直接存款形式得到償付。 欲瞭解詳情,請瀏覽「提交償付申請」頁面。

按一下這裡 查看 SF MRA 名下符合償付資格的醫療保健支出詳細清單。醫生辦公室看診、共付醫療費、醫療保險費、眼鏡和隱形眼鏡以及處方藥和非處方藥等眾多費用均有資格得到償付。

償付申請通常會於 3-5 個工作日內處理。

若您提交的償付申請款額大於您的賬戶餘額,最高支付額度為全部餘額。

否,您可以提交低至 0.01 美元的償付申請,並仍可以支票或直接存款形式獲得償付。

否,您可以支票或直接存款形式獲得低至 0.01 美元的償付。

您不再為繳納 SF MRA 存款的僱主工作之後,仍可以使用自己賬戶中的款項。 只要賬戶處於活躍狀態,您就可以使用 SF MRA 款項。 您可以每 24 個月至少提出一次 SF MRA 償付申請使賬戶處於活躍狀態。 如果在連續超過 24 個月內沒有提出請求或存入存款,我們的計劃將關閉該 SF MRA ,您將無法再使用 SF MRA 款項。

如果一位僱員的 SF MRA 已經被關閉而他們希望將其重新開啟,他們可致電 1(415) 615-5720,同時我們會返還 SF MRA 資金。

即使您不再為僱主工作,您仍可使用您的 SF MRA 提交償付申請。

請致電 SF MRA 客戶服務部,電話:(866) 697-6078 ,查詢您的賬戶餘額。 您也可以瀏覽mymra.wageworks.com,線上查看您的賬戶餘額。

請致電 SF MRA 客戶服務部,電話:(866) 697-6078,查詢您的償付申請狀態。 您也可以瀏覽 mymra.wageworks.com,查看您的償付申請狀態。

請撥打 SF MRA 客戶服務電話 (866) 697-6078

是的,您仍能存取您的 SF MRA 賬戶和提出符合條件的費用的索償,即使您遷居到本州外或另一個國家。在您向 WageWorks 提出索償時,您的索償文件與付款證明必須是英文,並且索償金額必須是美元。

SF Covered Medical Reimbursement Account (SF Covered MRA)的僱員相關規定

(English) 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 healthcare 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.wageworks.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.

(English) 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

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

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

(English) 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.

(English) 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.

(English) 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.

(English) 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.

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

(English) There are no fees for having a SF Covered MRA.

(English) 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.

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

(English) Claims are usually processed within 3 to 5 business days.

(English) 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.

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

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

(English) 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.

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

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

(English) 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.

(English) 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.

(English) 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.

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

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