Employee FAQs

Your San Francisco Medical Reimbursement Account (SF MRA) is a benefit in the SF City Option program. Funds in an SF MRA come from a past or current employer.

Funds can be used to pay back you, your spouse or domestic partner, and your dependents for eligible health care costs.

You can still use your SF MRA funds even if you no longer work for the employer who made the deposits. SF MRA funds are available to spend if your account is active.

Check to see if you have funds in an SF MRA. .

Use the SF MRA Funds Finder to see if you have an SF MRA.

You may be able to get an SF MRA if your current or past employer made payments to SF City Option for you. Use the SF MRA Funds Finder to see if you have funds waiting for you.

First, check the  Funds Finder to make sure you have funds available in an SF MRA. If you have funds, the next step is to enroll in the program. You can do this by filling out an SF MRA Enrollment Form. Then, we will follow up within 3 weeks to let you know how to get your SF MRA funds.

To keep your account active, you must send in at least one SF MRA claim every 36 months.

If there are no claims or employer deposits in over 36 months, your account will close. You will also not be able to use the SF MRA funds once your account is closed.

You can still use your SF MRA after you stop working for an employer who made the payments.

The San Francisco Health Commission approved a policy in 2022 to permanently close accounts that have not been used for a 3-year consecutive period. Any funds in those account will also be permanently given back to the City and County of San Francisco. This policy is consistent with existing state law (Government Code 50050).

The policy is effective March 1, 2023. That means the SF City Option program will begin tracking accounts that have had no activity for a three-year consecutive period beginning March 1, 2023, and beyond. The earliest any accounts could potentially be permanently closed is April 2026.

There is a $3.15 fee taken away from your available funds in your SF MRA monthly, whether you use the account that month or not. Fees will not be taken from the account if the available balance is less than $3.15.

In San Francisco, local laws require many employers to give health benefits to their eligible employees. San Francisco City Option (SF City Option) is a health benefit program that employers choose to meet this requirement. Your San Francisco Medical Reimbursement Account (SF MRA) is the benefit given to you within the SF City Option program.

If you have an SF MRA, it means that one or more of your employers, since 2008, put funds into SF City Option for you, to follow the law.

• Confirm that you worked at least 8 hours per week in San Francisco.
• Confirm that you worked for the company for at least 90 days.
• Confirm that you worked in the geographic boundaries of San Francisco. Fort Mason and The Presidio are on federal land, and are not considered part of the City and County of San Francisco.
• Confirm that your employer had 20 or more employees (globally), with at least one employee working in San Francisco.
• Confirm that you were not a government employee or worked for a City contractor.
• Reach out to your employer to find out what health benefits they gave you while you were an employee.
• • If you met the criteria above and did not get any health benefits, reach out to the Office of Labor Standards Enforcement. Ask about filing a complaint if the violation occurred in the last 3 years.

Check the SF MRA Funds Finder to see if you have existing funds in an SF MRA.

Yes. Health insurance premiums, co-payments, health care payments, and deductibles are covered health care expenses. You can send in a claim to get money back through your SF MRA.

Funds in your SF MRA can be used to pay back you, your spouse or domestic partner, and your dependents for covered health care costs.

A dependent is a child or relative who lives with you for more than half the year. They must also get more than half of their financial support from you.

Dependents may include full-time students ages 19 through 26 and children over age 19 who are permanently disabled.

To qualify as a dependent, a relative must:

• Get more than half of their financial support from you, and
• Not be your child, or the child of any other taxpayer

To see what health care costs are covered for reimbursement with your SF MRA, visit SF MRA Eligible Expenses page.

The information you put in the SF MRA Funds Finder search did not match any records in our system. This could mean you are not eligible for an SF MRA.

The information you put in the enrollment form did not match any records in our system. This could mean you are not eligible for an SF MRA.

Not everyone can get an SF MRA. You are not eligible if:

• You did not work in San Francisco since 2008.
• You are not covered under San Francisco’s Health Care Security Ordinance because you did not:
  • Work in San Francisco for at least 90 days, and
  • Work at least 8 hours per week
• You are not covered under San Francisco’s Healthy Airport Ordinance.
• An employer gave you another health benefit, such as health insurance or payments into a different reimbursement account.
• A different name, date of birth, or social security number was provided to us by your employer.
• You are a public employee, employed by the City or County of San Francisco, UCSF, the Federal Government, Cal State University, etc. Public employees are not covered under the Health Care Security Ordinance.

The information you put in the SF MRA Funds Finder might be a match with a record in our system, but either your name, date of birth, or social security number are different.

To determine if you are a match and are qualified, we need more information like your address, phone number, and the name of your employer(s).

To give us more information please fill out an enrollment form.

The information you put on your enrollment form might be a match to a record in our system. However, due to missing or incorrect information, we were not able to enroll you in the SF MRA benefit.

Please contact SF City Option customer service for more information. You can call us at  1(877) 772-0415 or you can email us at[email protected].

To find out how to access your SF MRA funds, visit the Enroll in SF MRA page.

Contact HealthEquity/EZ Receipts at 1(866) 697-6078 for help.

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

You can still use your SF MRA after you no longer work for the employer who made the payments. You can use your SF MRA funds as long as your account is active. Keep your account active by sending in at least one SF MRA claim every 36 months.

If there have been no claims or new deposits in over 36 months, your SF MRA will close. Once your account closes, you will not be able to spend SF MRA funds.

Please call HealthEquity/EZ Receipts at 1(866) 697-6078 to check your account balance. You may also check your account balance online at participant.wageworks.com/sfmra.

You can update this information online at participant.wageworks.com/sfmra You can also call SF City Option at 1(877) 772-0415 or go to [email protected] to learn more.

HealthEquity/EZ Receipts Customer Service is available 24 hours a day, 7 days a week to answer your questions about Medical Reimbursement Accounts. Please call HealthEquity/EZ Receipts Customer Service at  1(866) 697-6078.

Yes. You can still access your SF MRA account and send in claims for covered health care costs, even if you move out of state or to another country. Be sure to update your address in your Health Equity/EZ Receipts account. When you submit your claim to HealthEquity/EZ Receipts, your claim documentation and proof of payment must be in English, and the claim amount should be in dollars. If you have a bank account in the US, Health Equity/EZ Receipts can pay you back through direct deposit or send a check to your current address.

SF MRA funds may be available after a participant’s death. SF MRA funds may also be available for a spouse or domestic partner and dependents after the date of the account holder’s death.

An executor or legally authorized representative can send in claims for covered health care costs up to the date of the account holder’s death. You would also need to include this information:

• Date of account holder’s death
• Name of the authorized representative
• Relationship to the deceased
• Authorized representative’s address
• Authorized representative’s phone number
• One of the following: a Letter of Testamentary naming the executor, a copy of the court order appointing the administrator. OR, if no court-appointed representative exists, a completed Authorized Representative Declaration Form is needed.

You may send in receipts and claim forms online or by mail, fax, or mobile app and get paid back by check or direct deposit. To learn more, please visit the Enroll in SF MRA page.

Only covered health care costs on or after the effective date of your SF MRA are eligible for reimbursement. Your SF MRA effective date is the date an employer’s first payment for you clears in our system.

Claims are usually processed within 3 to 5 business days after they are sent in.

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

No, you may send in a claim for as little as $0.01 and can still get paid back by check or direct deposit for the claim.

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

No, you can send as many claims as you need. You will get paid back up to your available account balance.

No, you can only use your SF MRA funds by sending claims for reimbursement of covered health care costs.

Your employer should have sent a Health Care Payment Confirmation Notice to you after they made their first payment for you. 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 SF City Option Program, please reach out your employer or contact SF City Option at [email protected] to find out more.

If you feel that you should be getting some type of health benefit (health insurance, City Option benefit, or other benefit) please reach out to the Office of Labor Standards Enforcement at 1(415) 554-7892 or by email at [email protected].

Use the SF MRA Funds Finder to see if you have an SF MRA.

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