Health Care Security Ordinance (HCSO)

Announcements/Updates

Legal Challenge
June 28, 2010:  The United States Supreme Court has rejected the appeal of the Golden Gate Restaurant Association.  As such, the legal challenge is over.  The HCSO continues to be in effect for all covered employers.  For the history of the lawsuit, use this link.

2010 Annual Salary Exemption Figure
An employee who is a manager, supervisor, or confidential employee and who earns at or above an annual salary of $80,397 (or $38.65/hour) in 2010 is exempt from coverage under the HCSO.  Please review Regulation 3.2(A)(1) for a detailed definition of a manager, supervisor, or confidential employee.

2011 Health Care Expenditure Rates
The 2011 health care expenditure rate for large employers (100+ employees) will be $2.06/hour.  For medium-sized employers (20-99 employees), the rate will be $1.37/hour.

HCSO Email List
To be added to the HCSO email list to receive updates regarding implementation of this law, please send an email with "mailing list" in the subject line to HCSO@sfgov.org.

Effective January 9, 2008, the Health Care Security Ordinance (HCSO) requires Covered Employers to spend a minimum amount of money each quarter on their Covered Employees' health care.  For detailed information on the law's requirements, please see the Frequently Asked Questions and Regulations below.

• Final Regulations Implementing the Employer Spending Requirement of the Health Care Security Ordinance (PDF) posted 6/16/08

• Health Care Security Ordinance, Administrative Code Chapter 14

• Annual Reporting Form Worksheet (PDF)
• Annual Reporting Form (PDF)
  Remember:  Self-employed individuals, independent contractors, employers with 19 or fewer total employees (including any employees located outside of San Francisco), and nonprofits with 49 or fewer total employees total are not covered by the HCSO and should not return the Annual Reporting Form.
• Employee Health Care Payment Confirmation (PDF) (English) (Chinese) (Spanish)
• Employee Voluntary Waiver Form (PDF) (English) (Chinese) (Spanish)
• 2010 Notice to Employers (PDF) (English) (Chinese) (Spanish)
• HCSO Complaint Form (PDF)
• Frequently Asked Questions (PDF) posted 2/5/10
• HCSO presentation re: 2010 Updates (PDF)
• Employer Spending Requirement (ESR) Calculator
• ESR Calculator (Excel) Please download and save this spreadsheet to your computer before attempting to use it.
• Q&A and Line-by-Line Instructions for the ESR Calculator (PDF)

• Healthy San Francisco
• Internal Revenue Service (IRS) Publication 502, Medical and Dental Expenses
• Office of the Treasurer & Tax Collector 
• United States Postal Service Zip Code Lookup Note that employers located in the Presidio (various zip codes) and SF International Airport (94128) are NOT covered.
• State Board of Equalization -- On May 1, 2009, the State Board of Equalization issued a notice regarding the taxability of surcharges imposed by businesses in response to of the Health Care Security Ordinance. For more information, please use this link. To reach the State Board of Equalization, please call 800-400-7115.

Please email HCSO@sfgov.org or call 554-7892 with any questions regarding your rights and responsibilities under the San Francisco Health Care Security Ordinance.