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San Francisco outlines plan to reclaim unclaimed 'City Option' funds; $144M moved to active accounts
Summary
DPH reported outreach successes converting $144 million from an unassigned City Option fund pool into employee medical reimbursement accounts, described the three-year in-shipment/escheat timeline (earliest initiation mid-April 2026) and previewed tools and outreach to help workers claim funds before money is transferred to the city general fund.
Stella Chao, director of managed care at the San Francisco Department of Public Health, briefed the Health Commission on May 2 on the San Francisco City Option program and the in-shipment policy the commission approved in January 2022.
How the program works: Under the health-care security ordinance, employers contribute on employees' behalf into a City Option fund. When employees activate a San Francisco Medical Reimbursement Account (SFMRA), future contributions go directly into that account and employees can file claims for eligible medical expenses. Chao said the city has worked with the Treasurer and Tax Collector (TTX) and controller to place…
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