San Francisco Releases Expenditure Rates for Health Care Security Ordinance
Author
San Francisco recently released the required 2027 expenditure reate for its Health Care Security Ordinance (HCSO).
The HCSO requires covered employers to spend a certain dollar amount on health care (i.e. medical, dental, vision, prescription drug) for its covered employees.
Calculating Required Healthcare Expenditures
The minimum health care expenditure for each covered employee is determined quarterly by multiplying the employee’s total number of payable hours in the quarter by the applicable health care expenditure rate. Payable hours include hours paid and hours entitled to payment, such as paid time off or paid leave, earned within San Francisco.
Quarterly Payment Requirements
Covered employers must make irrevocable health care expenditures each quarter no later than 30 days after the end of the preceding quarter. Simply providing additional pay to the employee is not considered a valid health care expenditure.
Self-funded Health Plans
Employers with self-funded health plans must calculate the value of those plans, and pay any necessary top-offs, by February 28th each year for the prior calendar year. For more information contact your OneDigital Consultant. Details and training are also provided in the Special Cases>Self-funded Employers section at https://www.sf.gov/information--health-care-security-ordinance
Note: Compliance with the HCSO employer spending requirements does not alleviate the need for applicable large employers to comply with the Affordable Care Act (ACA) Employer Shared Responsibility provisions. Additionally, amounts paid for health care expenditures that satisfy the ACA may not fully satisfy the HCSO employer spending requirement.
2027 HCSO Expenditure Rates for Employers
|
Employer Size |
Small: Businesses with 0-19 employees and nonprofits with 0-49 employees |
Medium: Businesses with 20-99 employees and nonprofits with 50-99 employees |
Large: All employers with 100 or more workers |
|---|---|---|---|
|
2026 Expenditure Rate |
Exempt |
$2.75 per hour payable; maximum monthly spend of $471.28 |
$4.11 per hour payable; maximum monthly spend of $706.92 |
|
2027 Expenditure Rate |
Exempt |
$2.99 per hour payable; maximum monthly spend of $514.28 |
$4.49 per hour payable; maximum monthly spend of $772.28 |
As a reminder, all employers covered by the HCSO must:
- Meet Employer Spending Requirements (ESR) by making required health care expenditures on behalf of all covered employees;
- Maintain records showing compliance with the ESR;
- Post a notice in the workplaces with covered employees; and
- Submit an annual reporting form to the Office of Labor Standards Enforcement (OLSE).
Covered Employers and Employees
An employer is covered by the HCSO for any calendar quarter if it meets the following three conditions:
- employs one or more workers within the geographic boundaries of the City and County of San Francisco;
- is required to obtain a valid San Francisco business registration certificate, and
- is a for-profit business with 20 or more employees or a nonprofit organization with 50 or more employees. The employer must count all employees for this purpose – not just those working in San Francisco
An employee is considered to be a covered employee if they work for a covered employer and:
- is entitled to be paid the minimum wage;
- has been employed by their employer for at least 90 calendar days;
- performs at least 8 hours of work per week within the geographic boundaries of San Francisco; and
- does not meet one of the exemption criteria
- Beginning January 1, 2027, managers and supervisors that at least $63.35 per hour or $131,763 per year are exempt
Employer Reporting Requirement
Covered employers are required to submit an Annual Reporting Form each year by May 2nd. Even employers who already meet minimum spending requirements through their company-paid premiums are required to do annual reporting.
The filing is done on-line. Regulators typically make the form available by April 1 each year. Employers can sign up for an email notification each year when the form is available: https://sfgov.org/olse/email-sign-employers-20-or-more-employees
The reporting asks for details on the number of employees eligible for HCSO as well as the company’s spending on health care premiums and contributions to HSAs or the San Francisco-run City Option.
Notice and Record Retention Requirements
Covered employers must post the unaltered official OLSE notice in a conspicuous place at any workplace where any covered employee works. Additionally, for a period of four years from each covered employee’s date of employment, a covered employer must keep the following records: (1) itemized pay statements; (2) the employee’s address, telephone number, date of first day of work; (3) records of health care expenditures made; (4) documentation supporting any employee exemption; and (5) documentation of quarterly health care expenditures.
Penalties
Failure to comply with the HCSO may result in maximum administrative penalties for the following violations:
|
Violation |
Failure to make the required minimum Health Care Expenditures within five business days of the quarterly due date (30 days after the conclusion of each quarter) |
Failure to submit the Annual Reporting Form |
Retaliation against employees |
Refusing to allow OLSE access to employer records |
Failure to maintain or retain accurate and complete records |
Failure to post the Official HCSO Notice |
|---|---|---|---|---|---|---|
|
Maximum Penalty |
$100.00 for each employee for each quarter that the violation occurred |
$500.00 for each quarter that the violation occurs |
$100.00 for each person who is the target of the prohibited action for each day the violation occurs |
$25.00 for each worker whose records are not provided for each day the violation occurs |
$500.00 for each quarter that the violation occurs |
$25 per day for each workplace or job site where the Notice is not posted |
If you have questions about your HCSO compliance responsibilities, contact your OneDigital consultant.