Office of Labor Standards Enforcement

Effective July 1, 2001, the Health Care Accountability Ordinance (HCAO) generally requires City contractors and certain tenants to offer health plan benefits to their covered employees, to make payments to the City for use by the Department of Public Health, or, under limited circumstances, to make payments directly to their covered employees.

The HCAO has been amended (see "HCAO Amendments" below).  These amendments take effect May 31, 2009.

Effective May 31, 2009, covered employees are those that work at least 20 hours per week on a City contract.

Effective July 1, 2009, the fee option for contractors/tenants is $3.00 per hour, capped at $120.00 per work week.

Note: beginning in 2009, each July 1 the fee option will be adjusted for inflation.
 

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HCAO Amendments - Effective May 31, 2009

For the full text of the Ordinance, use the link below:

• Health Care Accountability Ordinance, SF Admin Code, Chapter 12Q
  

• Regulations Implementing the HCAO (PDF) - Effective July 1, 2009 
• Regulations, released November 1, 2008 (PDF)
• Regulations, released May 10, 2002 (PDF)
  
  
  

• Minimum Standards for Health Plan Benefits (PDF) updated July 1, 2009
• Minimum Standards for Health Plan Benefits (PDF) effective 11/1/2008
• Resolution No. 19-08 Amending the Minimum Standards and Supporting Other Modifications to the HCAO (PDF)
• Minimum Standards for Health Plan Benefits (PDF) effective 9/1/2004
• Resolution No. 10-04 Amending the Minimum Standards and Supporting Other Modifications to the HCAO (PDF) adopted July 20, 2004
• Resolution No. 13-01 Approving and Adopting Minimum Standards For Health Plan Benefits In the Healthcare Accountability Ordinance (PDF) adopted June 19, 2001
  

• HCAO Employee Notice (PDFs) updated!  Required Posting
       (English     Spanish     Chinese     Russian     Vietnamese     Tagalog)
• Know Your Rights & Voluntary Waiver Form (PDF) updated!  Employers must maintain copies signed by employees.
• HCAO Payment Option Form updated! (Excel    PDF)
• Employee Complaint Form (PDFs)
       (English     Spanish      Chinese     Russian     Vietnamese)
• HCAO Subcontractor Information Form (PDF) This form must be filled out by the Prime Contractor, who is responsible for the Subcontractor's compliance.
• HCAO - MCO Comparison (PDF) updated!
  

• MCO/HCAO Instructions For Professional Services Agreements 
• MCO/HCAO Statutory Exemptions and Waivers 
• HCAO Contractor Compliance Declaration (Word)    (PDF)

The following forms may be found on the City's Intranet:

• MCO Form P-360 Exemption & Waiver
• HCAO Form P-365 Exemption & Waiver
  

Free and Low Cost City Resources for Uninsured Employees:

• Healthy San Francisco
• Health Clinic Information (PDF)
• Health Clinic Map (PDF)
• Healthy Families (outside of SFGov.org)