Provider Benefits

Health & Dental Coverage

Providers are covered under HEALTHYWORKERS, which is administered by San Francisco Health Plan (SFHP) and includes doctor visits, hospitalization, pharmacy services, and vision care. Dental coverage is offered under Liberty Dental Plan.

Coverage Termination

If you do not have 25 or more authorized hours for 3 consecutive months, your health and dental insurance will be terminated. The Public Authority will notify you by letter a month before your insurance ends. If your insurance is terminated, you must complete a new application form and meet the corresponding eligibility criteria before your insurance can start again.

Coverage Eligibility

HEALTHYWORKERS: when you are authorized to work for 2 consecutive months for at least 25 hours a month, you are eligible to apply for coverage for yourself.

Liberty Dental Plan: when you have worked and been paid by IHSS for 6 consecutive months for at least 25 hours a month, you are eligible to apply for coverage for yourself.

Applying for Coverage

Applications are automatically mailed to those who are eligible. Fill out the application form and mail or hand deliver it to the Public Authority. If your application form is received by the Public Authority on or before the 12th of the month, your coverage will start on the 1st day of the following month.

Have a quick question?

For further questions regarding health and dental benefits, look through our Frequently Asked Questions below. You can also text your question to 415-593-8125. Please allow time for a response.

* By sending a text, you have agreed that your phone number will be used for SMS message notifications sent by the San Francisco IHSS Public Authority. Message and data rates may apply.

Frequently Asked Questions

Eligibility & Enrollment

Premiums

Open Enrollment

Dental Plan Enrollment

  • Who is eligible for dental benefits?

    In order to be eligible, data records must show that you are authorized and were paid to work 25 or more hours a month for six months. You will continue to be eligible as long as you continue to work at least 25 hours a month.

  • What is the best plan for me?

    The Public Authority offers two good options for dental benefits. The EPO plan allows you to pick from a large network of dentists. This plan covers 80% or more of the cost of most services. The LDP100 plan provides services through a smaller group of dentists with no co-payment for most services. See the attached Comparison of Benefits and decide which is the best plan based on your needs.

  • How do I enroll in the new dental plan?

    Review the enclosed Comparison of Benefits and choose your plan. Complete and sign the Enrollment Form and send it to the IHSS Public Authority in the enclosed envelope.

  • When do I have to send in my Enrollment Form and when will my coverage start?

    Your completed and signed Enrollment Form must be received by the IHSS Public Authority on or before the twelfth of any month to be effective the first of the following month.

  • How will I know when I am enrolled?

    You will receive an ID packet from LIBERTY welcoming you to the plan. You should wait until you receive this packet to obtain dental services.

  • How much will the plan cost me?

    You are required to pay a monthly premium contribution. The amount you contribute is dependent on the plan you enroll in:

    • LDP100 Plan: Employee Only - $1 per month
    • LDP100 Plan: Employee + 1 dependent - $2 per month
    • LDP100 Plan: Employee + 2 or more dependents - $3 per month
    • EPO Plan: Employee Only - $2 per month

    In addition to your monthly fees, you may be required to pay a share of the cost for some of the services you receive. See the attached Comparison of Benefits for any additional co-payments that might be required.

  • How will I pay for my dental coverage?

    If you elect to have dental coverage, the premium contribution will be deducted from your paycheck each month.

  • Will my family be covered in the new plan?

    Dependent coverage is only available under the LDP100 plan. There is an additional monthly cost for dependent coverage. For a premium cost of $2 per month you may add one dependent to be covered by the LDP100 plan.

    For a premium cost of $3 per month you may add 2 or more dependents to be covered by the LDP100 plan. You may not add dependents to the EPO plan.

  • Who is an eligible dependent?
    • Legal spouse. You must submit a copy of a county or state issued marriage certificate to be able to enroll your spouse.
    • Domestic Partners and their children. A domestic partnership is established when persons meeting the criteria specified by California Family Code section 297 file either a Declaration of Domestic Partnership (Form NP/SF DP-1) or a Confidential Declaration of Domestic Partnership (Form NP/SF DP-1A) with the California Secretary of State. A copy of the declaration and a Certificate of Registration of Domestic Partnership will be returned to the partners after the declaration is filed. You must submit the Certificate of Registration of Domestic Partnership with your enrollment form to be able to enroll your domestic partner.
    • Children up to the age of 26. You must submit a copy of a birth certificate, proof of adoption, foster care agreement or guardianship court order to be able to enroll your child.
    • Dependent children over the age of 26 with disabilities who are dependent upon you for support and are not able to support themselves due to physical or mental disability. You must submit IRS qualifying documents or SSI qualifying documents to be able to enroll your disabled child over the age of 26. Medical statements or legal documents can be considered.
  • Can I choose my own dentist?

    If you enroll in the LDP100 plan you can choose a dentist from the provider network provided in the enrollment packet. If you do not choose a dentist at the time you enroll, a dentist will be selected for you based on your home zip code and language preference. If you wish to change to another contracted dentist, you may do so by the 20th day of any month for the change to be effective the first day of the following month. If you choose the EPO plan you do not need to choose a primary care provider, but when you go to a dentist you should check the provider list to make sure your chosen dentist is an in-network doctor. If you need assistance with choosing a provider for either the LDP100 plan or EPO plan please contact LIBERTY Dental Plan at 1-888-703-6999. LDP100 providers can also be found by visiting www.libertydentalplan.com. EPO providers can also be found by visiting www.firstdentalhealth.com. Click on "For Members", then on "Find a Dentist", and when filling out the information on the next page, be sure to set it to "EPO" by "Select a Network". If you go to an out-of-network doctor, you may have a higher out-of-pocket expense.

  • Once I enroll in the LDP100 or the EPO, can I change to the other plan?

    You may change plans only during the annual open enrollment period. Open enrollment will take place in November and December of each year and is effective January 1st of the following year.

  • If I change my mind, can I drop dental coverage?

    Yes, you can voluntarily dis-enroll from the dental benefit plan at any time by providing written notice to the Public Authority. If your disenrollment is received by the twelfth of the month, dental coverage and premium withholding will end the first of the following month.

    If you voluntarily decide to terminate your dental coverage, you will not be allowed to re-enroll for dental benefits until the next Open Enrollment period. To re-enroll, you must also meet eligibility requirements, that is, have worked a minimum of 25 hours per month for the six previous months.

  • How long will I receive dental benefits?

    The dental benefit plan you select will continue as long as you are providing IHSS home care services. If you work less than 25 hours for two or more months you will lose eligibility for dental benefits.

  • How can I get my dental coverage restored if I lose it?

    If you lose your benefits, you must re-qualify by working a minimum of 25 hours per month for six consecutive months. Once this criteria has been met, you may re-apply.

  • If I lose my eligibility, can I purchase continued coverage?

    Federal law requires that all workers have the right to purchase their group coverage for a specific period of time after employment ends. You will be responsible to pay the full amount of premium to continue under this coverage. This law is called COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985). Once your eligibility ends, you will have 60 days to elect coverage with no lapse in coverage.

  • Who do I contact with questions about eligibility?
    • San Francisco IHSS Public Authority, Benefits Coordinator, Betty Hon, at 415-593-8125, www.sfihsspa.org.
    • About the benefits/procedures covered? LIBERTY Dental Plan at 1-888-703-6999.
    • About which providers I can see? LIBERTY Dental Plan at 1-888-703-6999.
    • You can text your question to 415-593-8125. Please allow time for a response.
      • By sending a text, you have agreed that your phone number will be used for SMS message notifications sent by the San Francisco IHSS Public Authority. Message and data rates may apply.

Forms / Information

Terminating / Ending Insurance

  • How long will I receive insurance benefits?

    The benefit plans you select will continue as long as you are providing IHSS services in San Francisco. If you work less than 25 hours for two or more months consecutively, you will lose eligibility for all benefits. A warning letter will be sent to you a month before termination date.

  • Can I voluntarily terminate my insurance?

    Yes, you can request to cancel health benefits by filling out a cancellation request form. If Public Authority received the form by the 12th of the month, your insurance will be cancelled effective the first day of the next month. If you canceled Health insurance, you can reapply anytime.

  • My recipient was in the hospital for two weeks and I was not paid, will I lose my benefits?

    If you should have a period of lower than 25 hours in any month, you will receive a warning letter, however if you are paid 25 hours or more the following month your benefits will not be affected. You will lose your benefits if you are paid less than 25 hours in three consecutive months.

    Remember: Your eligibility could be at jeopardy if you do not turn in your timesheets on time! We base your eligibility on paid hours data and the check issue date, not the hours worked. Please submit your timesheets as soon as the pay period ends.

  • How do I reinstate my eligibility before my insurance get terminated?

    If you worked and received paid for a minimum of 25 hours before insurance terminates, you must contact the number in the warning letter within 30 days from termination date for reinstatement.

  • Can I lose my benefits if I work in another county?

    If you no longer work in San Francisco, you will lose your insurance and you will need to apply with the county you are currently working. A warning letter will be sent to you a month before termination date.

  • I need to file taxes and require a 1095B (proof of Insurance).

    Your insurance company San Francisco Health Plan will mail out the 1095B form around March of each year.

  • How can I get my health coverage restored if I lose it?

    If you lose your benefit, you must re-enroll. Once the criteria(s) are met, you may re-apply again.

  • If I lose my eligibility, can I purchase continued coverage?

    Yes, you will be offered COBRA when insurance terminates. We have WageWorks as our COBRA administrator. You will automatically receive a COBRA packet with a given election period of 60 days to choose whether or not to continue with same coverage.

For Further Information

You may also download & print the same FAQs information inside
our PDF packet for the Health Benefits and Dental Plan Enrollment:

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