What are the 2021 San Francisco Health Care Security Ordinance (HCSO) required health expenditure rates for employers?

The San Francisco Office of Labor Standards Enforcement recently released updated Health Care Security Ordinance (HCSO) required health expenditure rates for 2021.

Effective January 1, 2021, the rate per hour will increase:

• from $3.08 to $3.18 for all Covered Employers with 100+ workers
• from $2.05 to $2.12 for for-profit Covered Employers with 20-99 workers and for non-profit Covered Employers with 50-99 workers.

For-profit employers with fewer than 20 workers and non-profit employers with fewer than 50 workers are exempt.

More information is available on the City of San Francisco HCSO website.

How much is a Covered Employer required to spend on health care for its Covered Employees?

The minimum Health Care Expenditure for each Covered Employee is determined quarterly by multiplying the total number of hours payable to the employee in the quarter by the applicable Health Care Expenditure rate.

Hours payable includes both the hours for which a person is paid wages for work performed within San Francisco and the hours for which a person is entitled to be paid wages, including, but not limited to, paid vacation, paid time off, and paid sick leave, but not exceeding 172 hours in a single month. Hours payable in a quarter refers to when the payment is earned, rather than when it is actually paid out to the employee.

The employer must make minimum Health Care Expenditures to or on behalf of each Covered Employee. Payments to or on behalf of one Covered Employee that exceed the required minimum Health Care Expenditure for that employee will not be considered in determining whether an employer has met its total required minimum Health Care Expenditures for all employees. There is an exception for employers that provide uniform coverage.

Note that “hours payable” is the figure used to calculate the expenditure required for each Covered Employee, but “hours worked” is used to determine whether an employee is covered by the HCSO.

Do hours worked by employees outside of San Francisco count for purposes of calculating expenditures?

No. Under the HCSO, hours payable includes only those hours during which the employee is working within the geographic boundaries of the City and County of San Francisco.

For Covered Employees who perform some work outside of San Francisco, hours payable that are not hours actually worked (e.g., paid vacation, paid time off, and paid sick leave) should be calculated on a pro rata basis.

Do hours payable include overtime hours? How are hours payable calculated for employees exempt from overtime law?

For employees who are not exempt from the overtime provisions of the federal Fair Labor Standards Act (FLSA) and California law, the Health Care Expenditures are calculated based on all hours worked, including overtime hours worked. Keep in mind that hours payable for each employee is capped at 172 hours per month.

For employees who are exempt from the overtime provisions of the FLSA and California law, the minimum Health Care Expenditures should be calculated based upon a 40-hour work week, capped at 172 hours per month, unless there is evidence that the exempt employee’s regular work week is less than 40 hours. In instances where there is evidence that the exempt employee’s regular work week is less than 40 hours, that figure shall be used in calculating the minimum Health Care Expenditures.