San Francisco Health Care Security Ordinance:

The San Francisco Health Care Security Ordinance (HCSO) provides individuals, who work in San Francisco and qualify as an employee entitled to minimum wage and who meet the hours worked requirement, with access to affordable health care through a Health Access Program. The HCSO requires Covered Employers to spend a minimum amount of money each quarter on behalf of their HCSO eligible employees' health care; i.e., those who have been employed for more than 90 days and who regularly work at least 8 hours per week in San Francisco.

Craford Benefit Consultants have developed deep expertise in interpreting the ordinance and designing specific health and welfare programs to many San Francisco based businesses to meet the requirements of the Health Care Security Ordinance. We are here to guide you through the complicated requirements and to help you structure plans that meet the regulatory requirements of the City, your employees’ needs, and your business objectives.

Health Care Security Ordinance (HCSO)

The San Francisco Health Care Security Ordinance (HCSO) requires Covered Employers to satisfy an Employer Spending Requirement by making health care expenditures for their Covered Employees, among other reporting and notice requirements. The San Francisco Office of Labor Standards Enforcement (OLSE) is responsible for enforcing the employer requirements of the HCSO.

Employers Covered Under the HCSO

An Employer is covered under the HCSO if it:

  • Is a for-profit business with 20 or more employees, or a non-profit business with 50 or more employees; and
  • Has employees who work in San Francisco.

Employees Covered Under the HCSO

  • With some exceptions, an Employee is covered by the HCSO if the Employee works for an Employer covered by the HCSO and;
  • Is entitled to be paid the minimum wage;
  • Has been employed by the Employer for at least 90 calendar days;
  • And, works at least 8 hours per week in San Francisco.

Employer Spending Requirement (ESR)

The Employer Spending Requirement of the Health Care Security Ordinance requires that a Covered Employer make minimum health care expenditures for each Covered Employee. The minimum health care expenditure amount is determined quarterly by multiplying the total number of hours paid to the Employee by the applicable health care expenditure rate. “Hours paid” include hours worked by the Employee plus any paid time off, including vacation, sick days, and holidays used by the Employee up to a maximum of 172 hours per quarter. Health care expenditures must be made at least quarterly, no later than 30 days, after the end of the preceding quarter

2016 Expenditure Rate:

  • All Employers with 100+ Employees - $2.53 per hour paid
  • For-profit Businesses with 20 - 99 employees - $1.68 per hour paid
  • Non-profit Businesses with 50 - 99 Employees - $1.68 per hour paid
  • For-profit Businesses with 0 - 19 employees - Exempt from HCSO
  • Non-profit Businesses with 0 - 49 Employees - Exempt from HCSO

2017 Expenditure Rate:

  • All Employers with 100+ Employees - $2.64 per hour paid
  • For-profit Businesses with 20 - 99 employees - $1.76 per hour paid
  • Non-profit Businesses with 50 - 99 Employees - $1.76 per hour paid
  • For-profit Businesses with 0 - 19 employees - Exempt from HCSO
  • Non-profit Businesses with 0 - 49 Employees - Exempt from HCSO

Employers can comply with the Employer Spending Requirement of the HCSO through various options, including:

  • Payments for health, dental, and/or vision insurance;
  • Payments into health savings/reimbursement accounts (in 2016);
  • Payments to the City Option Program.

Craford Benefit Consultants are ready to speak with you about your options. Let us demonstrate to you how we have made many San Francisco based businesses thrive in this legal environment.

San Francisco Health Care Accountability Ordinance:

The San Francisco Health Care Accountability Ordinance (HCAO) requires employers who are City contractors and certain tenants (such as the San Francisco International Airport and the Port of San Francisco) provide health plan benefits to their employees that meet specific minimum benefit and contribution standards.

Craford Benefit Consultants have developed deep expertise in interpreting the ordinance and designing specific health and welfare programs to many San Francisco based businesses to meet the requirements of the Health Care Accountability Ordinance. We are here to guide you through the complicated requirements and to help you structure plans that meet the regulatory requirements of the City, your employees’ needs, and your business objectives.

Health Care Accountability Ordinance (HCAO)

The San Francisco Health Care Accountability Ordinance (HCAO) requires Covered Employers to provide health insurance that meets a minimum benefit and contribution standard. The San Francisco Office of Labor Standards Enforcement (OLSE) is responsible for enforcing the employer requirements of the HCAO.

Employers Covered Under the HCAO

An Employer is covered under the HCAO if it:

  • Contracts with the City and County of San Francisco; or
  • Any person or entity that enters into a Contract with a Tenant or Subtenant to perform services on property covered by a Lease with the City and County of San Francisco.

Employees Covered Under the HCAO

  • A permanent employee of a Contractor or Subcontractor who works on a City Contract or Subcontract for 20 hours or more per week within the geographic boundaries of the city, or on real property owned or controlled by the City but outside of the geographic boundaries of the City; and
  • A permanent Employee of a Tenant or Subtenant who works 20 hours or more per week on property that is covered by a Lease or Sublease; and
  • A permanent employee of a Contractor or Subcontractor that has a Contract or Subcontract to perform services on property covered by a Lease or Sublease if the employee works 20 hours or more per week on the property.

Employer Requirement Components

The HCAO requires the covered employer provide to each covered employee who either resides or provides services in the covered geographic/contract areas one of the following:

  • Offer to the covered employee,  no later than the first of the month following 30 days of employment, a medical health plan that meets minimum standards that are prepared and reviewed every 2 years by the Health Commission; or
  • Pay to the City an hourly rate for the use of the Department of Public for each hour worked for each week in which the covered employees works the applicable minimum number of hours; or
  • Participate in a health benefits program developed by the Health Director in consultation with the Agency.
  • For employees who do not reside in San Francisco and do not provide services at the San Francisco Airport or at the San Bruno Jail the contractor may provide health plan benefits that meet minimum standards or pay to the covered employee an additional amount per hour.
  • All or any portion of these requirements may be waived in a bona fide collective bargaining agreement, provided that such waiver is explicitly set forth in such agreement in clear and unambiguous terms.

2015-2016 Alternate Pay Rate (changes each year in July):

  • $4.50 per hour up to 40 hours per week ($180 maximum)

2016-2017 Alternate Pay Rate (changes each year in July):

  • $4.65 per hour up to 40 hours per week ($186 maximum)

Craford Benefit Consultants are ready to speak with you about your options. Let us demonstrate to you how we have made many businesses thrive in this legal environment.