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.

For further questions regarding health and dental benefits,
look through our Frequently Asked Questions below or please call (415) 593-8125.

Frequently Asked Questions

Eligibility & Enrollment

  • What are the eligibility criteria to apply for Healthy Workers, VSP and Liberty Dental Insurance?
    • Health and Vision coverage: date records must show that you are authorized and were paid to work with a minimum of 25 hours for the most current 2 consecutive months.
    • Dental: date records must show that you are authorized and were paid to work with a minimum of 25 hours for the most current 6 consecutive months.
  • How do I enroll for insurance?

    Newly eligible IPs will automatically receive enrollment packets.

    • Health & Vision - must show that you are authorized and were paid to work with a minimum of 25 hours for the most current 2 consecutive months.
    • Dental - must show that you are authorized and were paid to work with a minimum of 25 hours for the most current 6 consecutive months.
  • Where can I get an application?

    If you need an application because you are not enrolling for the first time (and did not automatically receive an application), you can get an application: 

    • At 832 Folsom Street, 9th floor, SF CA 94107
    • Call 415-243-4477 and ask for one to be mailed to you.
    • Email info@sfihsspa.org and request one to be mailed to you.

    Applications are available in English, Chinese, Spanish, and Russian.

  • Is there a deadline for the application if I want insurance to start next month?

    Yes, our monthly deadline is the 12th of each month.

  • How long does it take after I submit my application for my insurance to start?

    Once you have met the eligibility requirements, it may take up to 60 days for your coverage to begin.

  • How do I know I’m enrolled after I submit the application?

    When you are enrolled, you will receive an ID card from the Insurance company welcoming you to the plan.  You should wait until you receive these packets to obtain services.

  • What if I don’t receive my ID Card?

    Contact SFHP Healthy Worker if you have not received your ID card within 60 days of submitting your application to check the status.

  • Can I add spouse or dependents to my Insurance?
    • Health and Vision – NO (This is an Employee only coverage)
    • Dental - YES but need proper documentation.
      • Spouse – marriage license
      • Legal domestic partner – Certificate of Domestic Partnership
      • Children under 26 – Birth Certificate
      • Children 26 or above with disability – Birth Certificate and Doctor’s note

    If the required documents are not available, IP can use the most current tax return as supporting documents.

Premiums

  • What is an insurance premium? How will I pay for my premiums?

    An insurance premium is the amount of money an individual pay for an insurance policy. It is a monthly fee. 

    The premium contributions will be deducted from your second paycheck each month.

  • How much are the premiums?
    • Health and Vision- $3/month
    • Dental- $1-$3/month. The amount you contribute depends on the plan you enroll.
      • 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

Open Enrollment

Forms / Current Recipient 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 home care services.  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.

  • My Recipient was in the hospital for two weeks and I was not paid, will I lose my health 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 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 Voluntarily Terminate my insurance?

    You can request to cancel health and dental benefits by filling out a cancellation request form. If Public Authority received the form by the 12th of the month, your insurance will be canceled effective the first day of the next month.  If you canceled Health insurance you can reapply anytime, but once you canceled your dental insurance, you must wait till Open Enrollment to re-enroll.

  • 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 COBRA packet when your insurance terminates.

  • How can I get my Health and dental coverage restored if I lose them?

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

For Further Information

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