HR Benefits Summary

One Peter Yorke Way
San Francisco CA 94109

Phone 415-614-5540
Fax 415-614-5536

California Individual Mandate Act Senate Bill 78

Effective January 1, 2020, the California legislature enacted the Minimum Essential Coverage Individual Mandate Act.  The individual mandate requires each California resident to ensure that the individual, and any spouse or dependent, are enrolled in minimum essential coverage (MEC) for each month or pay a penalty.

What does the California Individual Mandate Act mean to you?

 If you are not currently enrolled in any medical coverage, you should enroll in a medical plan meeting the Minimum Essential Coverage, or you may have to pay a penalty on your CA income tax return filed in 2021.  An adult who is uninsured in 2020 can be penalized a state tax charge of $695.00 or 2.5% of his or her gross income. A family of four could pay a penalty of at least $2085.00.
All Reta plans meet the minimum essential coverage (MEC) requirement, so anyone enrolled in a Reta plan, will meet the mandate requirement for each month of coverage.
If you are not currently enrolled under a Reta medical plan, but covered under other health coverage (such as another employer’s group health plan, Medicaid, Medicare, a plan through the Covered California Marketplace, or other individual coverage that meets the MEC standard), you are not required to enroll in a plan through your employer and will meet the mandate requirement.

Benefits Summary

Dental Plan – Delta Dental of California
  • Primary enrollee, spouse and eligible dependent children to the end of the month dependent turns age 26.
  • Delta Dental PPO dentists:
    $50 per person / $150 per family each calendar year
  • Non-Delta Dental PPO dentists:
    $75 per person / $225 per family each calendar year

    See Dental Plan Highlights for more information.


Delta Dental of California   Phone: Customer Service 800-765-6003    

 Note: Eligibility – Employees who regularly work 20 or more hours per week

Medical Plan

Following choices are available:

Note:  Eligibility –  Employees who regularly work 20 or more hours per week

Vision Plan
  • Choose between Kasier Vision EyeMed (new in 2023) depending on your Medical Health Plan.
  • Covered for all employees. Kaiser EPO eligible dependents are covered; Anthem Blue Cross EPO eligible dependents are not covered
  • For those employees choosing Blue Shield, (EyeMed in 2023) provides the vision coverage.  

Note:  Eligibility – Employees who regularly work 20 or more hours per week

Note: (New in Year 2023) Medical Eye Services (MES), our Blue Shield vision care provider, has joined EssilorLuxottic, as a result the MES plans expired in December 31, 2022 and is now EyeMed Vision Care effective January 1, 2023 for all employees in the Blue Shield plan. See EyeMed.


For those employees choosing Blue Shield, CVS CaremarkRx provides prescription coverage.  Go to for info & locations

Basic Life Insurance, AD&D, Long Term Disability

Eligibility: Each Active, Full-time employee working 20 or more hours per week, except any person working on a temporary or seasonal basis.
Employer pays 100% of the premium at no cost to employee.
Your beneficiary will receive $10,000.00. Provides a cash benefit to help ensure your loved ones remain financially secure in the event of your death or a covered accident. Benefit reduction commencing at age 70.
LTD is intended to help replace some of your income for an extended period when you cannot work because of a disability. Elimination Period of 90 days. Monthly benefit of 66 2/3% of monthly salary up to $4,000 per month. Integrated with other disability benefits you may receive.

See Plan Highlights for more information.

San Francisco HCSO

Employees working 8 hours a week or more in SF have option to elect HCSO. Employer contributes to HCSO plan per hour paid to employee. Employer pays 100% of premium. Eligible after 90 days employment.

403(B) Plan
  • All benefited employees are eligible for the 403(B) Plan
  • No enrollment applications needed
  • Once you have received your 1st paycheck is when your record will be created in the Fidelity system.  
  • Please wait until one week after your 1st payroll check to add your percentage to the Fidelity website
  • Log into Fidelity NetBenefits ( or call Fidelity representatives at 800-343-0860
  • Please see 403(B) Plan Highlights for more information

Note:   Eligibility –  Employees who regularly work 20 or more hours per week

Pension Plan
  • All Benefits Eligible employees hired or rehired are automatically enrolled in the Archdiocese of San Francisco Retirement Plan.
  • The Pension plan is 100% funded by ADSF and administered by Nicolay Pension Services (800) 867-0780.

See more on Parochial Pension Plan Booklet and Beneficiary Designation form.

  Note:  Eligibility –  Employees who regularly work 20 or more hours per week

Voluntary Life and AD&D Plans

Voluntary Life and AD&D plans are available to all new hires and during open enrollment period. Coverage available to employee and eligible dependents

Cost to these plan are 100% paid by the employee.

Flexible Spending Account (HCFSA)

HCFSA allows you to set aside a portion of your salary, before-tax, to reimburse amounts for eligible medical expenses.  Please see FSA Enrollment kit and FSA Enrollment Instructions.

Also see FSA Claim Form.

Note: FSA enrollments are done yearly in November for the next January / calendar year.

Flexible Spending Account (DCFSA)

DCFSA allows you to set aside a portion of your salary, before-tax, to reimburse amounts spent for eligible dependent day care expenses that are necessary in order for you, and if you are married, your spouse, to work or look for work.

Note: FSA enrollments are done yearly in November for the next January / calendar year.

Transportation Reimbursement

The transportation reimbursement you to set aside money on a pre-tax basis for out of pocket work related transportation expenses.  (e.g. bus vouchers and passes, ferry passes, van pool, commuter rail.) Please see Sec. 132 Enrollment Guide and Sec. 132 Enrollment Form.

Sec. 132 Claim Form
Note: FSA enrollments are done yearly in November for the next January / calendar year.

Health Benefit Vendor Contact


Blue Shield
Group ID #: W0072386 
Grp Name: RETA Trust
(888) 772-1076

CVS Caremark Rx
Group ID# RX21AE Bin:004336 PCN:ADV
(800) 844-0719

Reta Kaiser Medical & Pharmacy Plan
Group ID #: 603978
(800) 464-4000


Delta Dental of California
Group ID #: 18367
(800) 765-6003

(866) 939-3633


Basic Life / AD&D
Group ID #: GL155879
(800) 351-7500

Long-Term Disability (LTD)
Group ID #: GLT-677870
(800) 549-6514


Employee Assistance Program (EAP)
Code: ArchdioceseSF
(866) 248-4104

Reta Trust
(877) 303-7382

Workers Compensation

This benefit is for work-related illness or injury.

Employee must use employer approved clinic by default.

Employee can predesignate their personal physician in writing but has to do so prior to a workplace injury/illness, otherwise s/he must see a doctor within our

Medical Provider Network (MPN).

Our present workers’ compensation provider is GuideOne Insurance.

See for more information.

Please read more on Notice to Employee – (DWC-7) and Notice to Employee from GuideOne Insurance.

DWC-1 form will be provided by our Benefits Administrator to injured/ill employee within one day of date of injury/illness to start the claim process.

Employee Assistance Program (EAP)

Employees and their immediate families may access EAP for 24/7 hotline, up to 8 free counseling sessions per issue per year per person.

See for more information. (access code from our Benefits Department is required)