In a recent meeting held by the City of San Francisco, officials discussed significant updates regarding the Healthcare Security Ordinance and the City Options program, which aims to enhance healthcare accessibility for city employees. The ordinance mandates that employers contribute funds to employees' City Options accounts, allowing them to use these funds for medical expenses, including over-the-counter medications and prescription drugs.

The program, established in 2008, has seen fluctuating participation rates over the years. Notably, since 2014, there has been a marked increase in employer contributions, with total contributions reaching approximately $1.66 billion. However, a substantial portion of these funds remains unclaimed, with about 28% currently sitting in an unassigned fund pool, indicating a need for improved employee engagement and awareness.

During the meeting, officials highlighted the importance of outreach efforts to inform employees about their available funds. Recent initiatives have successfully moved $144 million from the unassigned pool to active accounts, allowing employees to access their funds. The city plans to continue outreach efforts, particularly as the deadline approaches for employees to activate their accounts before funds are reallocated to the city’s general fund in April 2026.

The meeting also addressed the implementation phases of the policy, which include establishing a bank account for the program and notifying employees and employers about the changes. Officials emphasized the necessity of creating tools for employees to check their account balances and ensuring that those without online access can still engage with the program.

Commissioners expressed concerns about the potential loss of funds for employees who do not utilize their accounts. It was clarified that as long as an account remains active with at least one claim within the three-year period, employees will not lose their funds. This policy aims to provide flexibility and encourage employees to utilize their benefits effectively.

Overall, the discussions underscored the city’s commitment to making healthcare more affordable and accessible for its workforce. As the program evolves, officials are focused on maximizing participation and ensuring that employees are well-informed about their options, ultimately striving to enhance the overall effectiveness of the Healthcare Security Ordinance.