Health Care Security Ordinance (HCSO)

 HCSO News

• The 2012 Annual Reporting Form is now available.  To avoid penalties of $500 per quarter, "covered employers" must submit the Form by April 30, 2013. Please review the Instructions for more information.

 Overview

• Under the Health Care Security Ordinance (HCSO), all covered employers must meet the following obligations:

1. Satisfy the Employer Spending Requirement by making required health care expenditures on behalf of all covered employees (those who have been employed for more than 90 days and who regularly work at least 8 hours per week in San Francisco) at the following rates:

2. Maintain records sufficient to establish compliance with the employer spending requirement.

3. Post an HCSO Notice in all workplaces with covered employees.

4. Submit an Annual Reporting Form to the OLSE by April 30th of each year. 

• For details about these and other requirements, see our Frequently Asked Questions, review our other resources, or contact the OLSE at hcso@sfgov.org or (415) 554-7892.
• Employees who believe their rights have been violated may submit an HCSO Complaint Form (PDF).

 Frequently Asked Questions

A. Overview
B. Covered Employers
C. Covered Employees
D. Calculating Required Health Care Expenditures
E. Making Required Health Care Expenditures
F. Contributing to Reimbursement Accounts
G. Contributing to the City Option

H. Employer Notice-Posting Requirement
I. Employer Recordkeeping Requirements
J. Employer Reporting Requirements
K. Health Surcharges
L. Retaliation Prohibited
M. Filing a Complaint
N. Penalties

Download all FAQs (PDF)

 Email Updates

• Sign up for our HCSO Email List to get occasional updates about the Ordinance.

 General HCSO Resources

• Full text of the Health Care Security Ordinance.
• Full text of the Final Regulations Implementing the Employer Spending Requirement (PDF).
• 2013 Official Notice (PDF) (must be posted at workplaces as of January 1, 2013).
• 2013 Two-Page HCSO Summary (PDF).
• 2013 Employer Spending Requirement Calculator:
  • 2013 Calculator (Excel) please download and save spreadsheet before using.
  • Q&A and Line-by-Line Instructions for the 2013 Calculator (PDF).
• Employee HCSO Complaint Form (PDF) (English) (Chinese) (Spanish).
• Employee Voluntary Waiver Form (PDF) (English) (Chinese) (Spanish).

 Annual Reporting

• Employers covered by the San Francisco Health Care Security Ordinance are required to submit an Annual Reporting Form by April 30th each year.
  • The 2012 Annual Reporting Form
  • Instructions for the 2012 Annual Reporting Form 
  • Analysis of the HCSO 2011 Annual Reporting Forms (PDF).
  • Analysis of the HCSO 2010 Annual Reporting Forms (PDF).

 San Francisco City Option (Healthy San Francisco and Medical Reimbursement Accounts)

• One way that employers may comply with the HCSO’s spending requirement is by making contributions to the City Option on behalf of their covered employees. Depending upon eligibility, employees who receive these contributions will receive:
  • free or discounted enrollment in the Healthy San Francisco program, or
  • a Medical Reimbursement Account to pay for out-of-pocket medical expenses.
• Upon contributing to the City Option, employers must provide their employees with a one-time Employee Health Care Payment Confirmation (PDF) (English) (Chinese) (Spanish).
• To learn more about contributing to the City Option, contact City Option Program Management at employerservices@healthysanfrancisco.org or (415) 615-4492.

 Health Care Surcharges

• Businesses are neither required to, nor prohibited from, imposing surcharges on their customers to offset the cost of complying with the Health Care Security Ordinance. However, employers that elect to impose such surcharges must comply with specific requirements.
• On May 1, 2009, the State Board of Equalization issued a Special Notice (PDF) regarding the taxability of such surcharges. To reach the State Board of Equalization, please call 800.400.7115.

 Upcoming Administrative Hearings and Hearing Officer Decisions

• There are currently no hearings scheduled.
• May 1, 2012 - GMG Janitorial, Inc. (PDF)

 Contact Us

• 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.