The Department of Public Health headquarters at 101 Grove St.
The Department of Public Health has its headquarters at 101 Grove St. Photo by David Mamaril Horowitz.

Around $775 million sits in the San Francisco City Option program, a result of thousands of employers creating health benefit accounts and paying into them for more than 400,000 current and former employees.

But many employees who have worked in the city or at San Francisco International Airport don’t realize that their employer started a Medical Reimbursement Account for them, let alone that they must take action to access their funds. As a result, their accounts have been sitting dormant, and they have failed to access hundreds and even thousands of dollars that could be used for a wide range of medical expenses, from therapy to dental. 

Now more than ever, San Francisco is urging covered employees to use their accounts, because a three-year countdown begins in March. Starting in April, 2026, accounts that are inactive for three consecutive years will be closed and have their funds transferred to the city.

The following chart lists the 174 companies and nonprofit organizations that contributed to the program for the month of December 2022. It’s important to note that there are many more employers who are a part of the program; still, the list may be useful, particularly for people who’ve worked for one of the following employers, or know someone who’s worked for one.

The chart includes a minority of the employers who participate in the program. Many employers outside of the list contribute, as well. Click here to check if you have an account.

Biggest contributors to SF City Option

Among the $6.8 million paid into the program last month, some of the biggest contributors were employers that serve SFO: Gate Gourmet, an airline catering company, came in first with nearly $1.5 million in contributions.

Coming in second in contributions is Allied Universal Services, which provides security systems and services, as well as janitorial services and staffing. It paid more than $1.1 million into the program last month.

Whole Foods was ranked fourth, paying about $220,234. Another top contributor was Kaiser Permanente, which had about $197,578 listed under Kaiser Family Health, and $21,588 listed under Kaiser Family Health Plan.

Benihana, the famed Japantown eatery, was ranked seventh, with $128,000 going toward employees.

Also in the top 10 were tech giant Cisco and BlackRock, the advisory, investment and risk management solution company.

Mission contributors

In the Mission, numerous businesses contribute tens of thousands of dollars to SF City Option.

Foreign Cinema, the upscale restaurant on Mission Street, between 21st and 22nd streets, ranked 20th on the list, paying $45,026 into the program last month.

FedEx, which has locations at 2690 Mission St. and 1550 Bryant St., among many others citywide, ranked 11th and paid $91,343. There’s also 1Life Healthcare, the parent company of One Medical, which ranked 12th, paying $59,870, with a facility at 580 Valencia St.

Sports Basement — with three locations in San Francisco, one of them in the Mission at 1590 Bryant St. — ranked 24th, paying about $39,697 into the program. A block away, just outside the neighborhood, is Costco, which paid $36,660 into the program last month.

Further down the list are Burma Love and the Salvation Army, which each have a location in the Mission. Burma Love ranked 31st and paid $29,772 into the program, and the Salvation Army ranked 46th and paid $19,432.

Alamo Drafthouse, the theater-restaurant franchise with a location on Mission Street between 21st and 22nd streets, is not on the list, but previously paid into the program. Employees who previously worked there would do well to check if they have money saved up in their names.

There are more accounts than those on the December list

The December list is far from comprehensive, as it doesn’t take into account prior payments. People who might have funds in the program include those who’ve worked for employers who previously contributed to the program, as well as employees who previously worked for an employer who has contributed to the program. We will update the list as we identify employers and their contributions from previous years.

In San Francisco, companies with at least 20 employees, and nonprofit organizations with at least 50 employees, are required by city law to spend a minimum amount for qualifying employees. Employees who’ve worked an average of at least eight hours a week over a three-month period qualify. 

While employers often meet the city’s healthcare spending requirement by paying for employees’ health insurance, they can also use the City Option program to meet the healthcare spending requirement.  

Meanwhile, some companies that are a part of the airport’s Quality Standards Program also use SF City Option.

To find out if you have funds, former and current employees who’ve worked in San Francisco or at the airport can fill out the enrollment form here and wait one to three weeks; if an account was created in your name, completing the form will finish the account’s creation and grant you access to your funds.

Alternatively, people can contact SF City Option at (877) 772-0415 or, or ask their current or former employers.

To reset the three-year countdown and prevent an account closure, a participant must either file a claim for a medical reimbursement or finish setting up their account by enrolling; alternatively, if an employer is still paying into an employee’s fund, that keeps it from closing, as well.  

More than 135,000 people have funds under their name but can’t access them because they haven’t completed the enrollment form. Around $104 million sits in accounts that haven’t been touched in at least three years.

An earlier version of this noted a discrepancy between total funds in the chart and the amount paid in into the program last month. That was incorrect; there is no discrepancy.

Follow Us

David Mamaril Horowitz

David’s one of those San Francisco natives who gets excited whenever City College is mentioned. He has journalism degrees from there and San Francisco State University, graduating from the latter in May 2021. In college, David played five different roles as an editor at student news publications and reported as an intern for three local newspapers, mostly while waiting tables at the Alamo Drafthouse. His first job was at Mitchell's Ice Cream.

Join the Conversation


Please keep your comments short and civil. Do not leave multiple comments under multiple names on one article. We will zap comments that fail to adhere to these short and very easy-to-follow rules.

Your email address will not be published. Required fields are marked *

  1. Can you please figure out why UCSF doesn’t pay into this program as one of the city’s largest employers? I thought it was comical when searching for it herethat Columbia University showed up but UCSF didn’t. I also tried applying directly and there’s no account on my name either so I’m assuming they never paid into it

    1. Sir or madam —

      That’s an excellent question. We can look into it further, but off the top of my head I’d say it’s because UCSF is owned and operated by the state. This is also why UCSF is not subject to mitigation measures when undertaking developments.