Office of Labor Standards Enforcement

Quarterly Expenditures Due Within 30 Days of End of Quarter
For employers with 50 or more employees, the Employer Spending Requirement (ESR) of the Health Care Security Ordinance (HCSO) went into effect on January 9, 2008.  Covered employers with 50 or more employees must make health care expenditures for the first quarter by April 30, 2008.

April 1, 2008 is the date the law goes into effect for employers with 20-49 employees.  The first expenditure deadline for covered employers with 20-49 employees is July 30, 2008.

Employers that choose the City Option are required to provide Healthy San Francisco with a list of employees who will benefit from their contribution when they make their quarterly payments.  To register your employees and make payment for the City Option, use this link.  Note, however, that registering with Healthy San Francisco for the City Option is different from the required Annual Reporting, below.

Annual Reporting Form
The OLSE has determined that submission of the 2007 Annual Reporting Form is voluntary.  The information requested in the 2007 Annual Reporting Form will be helpful to the City to evaluate the effect of the Health Care Security Ordinance, and we encourage Covered Employers (those with 20 or more employees anywhere, including those outside of San Francisco) to submit the form.  Self-employed individuals, independent contractors, and employers with 19 or fewer employees should disregard the Annual Reporting Form.  Employers will receive the 2008 Annual Reporting Form at the end of the year.

Update on GGRA Litigation
In November of 2006, the Golden Gate Restaurant Association (GGRA) filed a lawsuit challenging the ESR of the HCSO. For more information about the lawsuit, use this link.  The hearing before the Ninth Circuit Court of Appeals was held on April 17, 2008, but a decision has not been issued.  Updates will be posted on our website as soon as they are available. 

HCSO Email List
To be added to the HCSO email list to receive updates on the litigation, presentation schedules, and other information 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 make health care expenditures for their Covered Employees and mandates the Department of Public Health (DPH) to create the Health Access Plan (HAP), now called Healthy San Francisco. Healthy San Francisco is only one option by which a covered employer can satisfy its obligation to make the required health care expenditure (HCE).  Covered Employers may also purchase health insurance coverage for their covered Employees, make payments to the City for the benefit of their Covered Employees, or make the required HCE in a variety of other manners. 

• For more information about Healthy San Francisco, use the link at the bottom of this page. 
• For more information about qualifying HCEs, review Regulations 4.1 & 4.3 in the Final Regulations and IRS Publication 502, using the links below.
• For more information about other HCE options, review Regulation 4.2.

Covered Employers are for-profit businesses with 20 or more employees and nonprofit businesses with 50 or more employees. All employees, regardless of where they live or work, must be counted for purposes of determining employer coverage. All members of a controlled group of corporations shall be considered one employer.

Covered employees include any person who has been employed by his or her employer for at least 90 calendar days and performs at least 10 hours of work per week within the geographic boundaries of the City and County of San Francisco.  (Use the USPS Zip Code Lookup in the Related Links section below if you are unsure about the geographic boundaries of the City and County of San Francisco.)

The health care expenditure rates for 2008 and 2009 are as follows:

Use the following links to download the following materials:

• Frequently Asked Questions (PDF) posted 12/7/07
• HCSO full presentation (PDF) handouts2 handouts6  posted 4/3/08
• HCSO condensed presentation (PDF) handouts2 posted 3/26/08
• HCSO/HCAO presentation (PDF) handouts2 posted 4/3/08
• Flowchart of Steps to Calculate the Minimum Required Health Care Expenditure (PDF)  posted 11/5/07
• ESR Calculator (Excel) posted 6/13/08 -- 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) posted 6/13/08

The OLSE Regulations Implementing the Employer Spending Requirement of the Health Care Security Ordinance have been finalized.  All oral and written comments submitted to the OLSE were considered in the final revisions to these regulations.  For more information about the rulemaking process, please use this link.  Final regulations were released on July 12, 2007.  For a copy of the final regulations, please use the following link:

• 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

• Notice to Employers (PDF) (English) (Chinese) (Spanish)
• Notice to Employee/City Option Deposit Confirmation (PDF) (English) (Chinese) (Spanish)  -- new document!
• Employee Voluntary Waiver Form (PDF)  (English) (Chinese) (Spanish)
• 2008 Notice to Employers (PDF)  -- newly revised document!
• 2007 Annual Reporting Form  -- for reference only -- Voluntary reporting must be done on the scannable form that was mailed in last week of January 2008 to the address listed on the employer's business registration form to be processed.  For questions about the mailing address listed on your business registration account, use the link for the SF Office of the Treasurer & Tax Collector in the Related Links section below.  Submission of the 2007 Annual Reporting Form is voluntary.   Use this link for Frequently Asked Questions about the Annual Reporting Form and Line-by-Line Instructions on how to fill out the form (PDF).   Employers will receive the 2008 Annual Reporting Form at the end of the year.

• Healthy San Francisco and the City Option
• Department of Public Health's Final Regulations Implementing the Healthy San Francisco and Medical Reimbursement Account Provisions of the HCSO (outside SFGov.org)
• San Francisco Department of Public Health (outside SFGov.org)

• Internal Revenue Service (IRS) Publication 502, Medical and Dental Expenses (outside SFGov.org)
• Office of the Treasurer & Tax Collector -- Pursuant to the SF Business & Tax Regulations Code, any individual or entity engaging in business in San Francisco for seven or more days a year must obtain a business registration certificate from the Office of the Treasurer and Tax Collector within 15 days of business operation.  For questions about business registration obligations, use the link above or call (415) 554-4400.
• United States Postal Service Zip Code Lookup -- For a general guide to the areas located within the geographic boundaries of the City and County of San Francisco, use the USPS Zip Code Lookup.  Note, however, that 94128, the zip code for SF International Airport, is NOT covered under this Ordinance.

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.