HCSO Compliance

The Health Care Security Ordinance (HCSO) is a San Francisco law that:

• established several employer health care-related obligations enforced by the Office of Labor Standards Enforcement (OLSE), and
• created a Health Access Program, including Healthy San Francisco and Medical Reimbursement Accounts, administered by the San Francisco Department of Public Health.

Requirements

Under the HCSO, all covered employers must meet the following obligations:

• Satisfy the Employer Spending Requirement (ESR) by calculating and making required health care expenditures on behalf of all covered employees.
• Maintain records sufficient to establish compliance with the ESR.
• Post an HCSO Notice in all workplaces with covered employees.
• Submit an HCSO Annual Reporting Form to the OLSE by April 30th of each year.

Employers choose how to make the required Health Care Expenditures for their covered employees. Common Health Care Expenditures include:

• Payments for health, dental, and/or vision insurance;
• Payments to the City Option;
• Contributions to programs that reimburse the employees for out-of-pocket health care costs, subject to the limitations described in Administrative Guidance Section F.

Learn More

To learn more about HCSO and a covered employer's obligations, use the links below:

• Health Care Security Ordinance
• HCSO Regulations
• Reporting Form (the 2019 form will be available in April 2020)
• Voluntary Waiver Form
• Payment Confirmation
• USPS Zip Code Lookup

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