Posted in Offering health benefits | by: Steve Johnsen

Healthy San Francisco: What It Means For Local Businesses

In 2006, the City of San Francisco created the Universal Healthcare Council (UHC) to help the City provide access to quality health care for its uninsured adults. One of the laws created and passed during this time was the Health Care Security Ordinance (HCSO). The HCSO required covered employers to pay a certain amount towards the health care costs of their employees.  The Department of Public Health then created the Health Access Program, now called Healthy San Francisco, to provide employers with a convenient way to satisfy their payment obligations to the HCSO’s health care expenditure requirements.

For some businesses, keeping up with the changes in employer health care obligations can be challenging. For those eligible, Healthy San Francisco might be able to help.

Is Healthy San Francisco health insurance?

Healthy San Francisco is not health insurance. It is a program designed to help uninsured individuals in the city find access to affordable health care services. The program also offers benefits to employers looking to adhere to the HCSO’s regulatory expenditure requirements.


health care compliance


How does Healthy San Francisco benefit businesses?

Healthy San Francisco is just one option for employers under the HCSO’s employer spending requirement. This program helps business owners meet their obligations through several available channels, including:

  • Providing access to affordable health insurance coverage (including medical, dental, and/or vision) for employees
  • Providing a means to reimburse employees for their out-of-pocket medical expenses
  • Providing the option of establishing employee health savings accounts

Employers who choose to participate in Healthy San Francisco’s City Option can take advantage of all of the benefits of Healthy San Francisco and its medical reimbursement accounts. Meanwhile, for small business owners in San Francisco, Healthy San Francisco offers a beneficial way to help uninsured or underinsured employees find access to quality health care.

What is the city option?

Healthy San Francisco’s City Option allows eligible employers to make their obligated health care contributions directly to the City. The collected funds can then be accessed by their employees and applied to either the cost of medical services offered through Healthy San Francisco or they can receive medical reimbursement accounts based on their eligibility criteria.

To join the City Option, employers simply need to register and create an account with Healthy San Francisco and select the “City Option.” In order to create an account, employers need to provide accurate employee rosters and itemize the amount of money being deposited on behalf of each employee.

Once the account is created, an employer can start depositing funds with the City on behalf of his or her employees and after the funds have been received, each employee will be notified as to where they can go to apply for the program. Those employees who are San Francisco residents and who qualify for the program will have their funds deposited directly into the Healthy San Francisco program where they can receive a 75% discount on program participation fees. Non-resident employees and residents who don’t qualify for the program will have their funds deposited into individual medical reimbursement accounts where the funds can be applied towards eligible out-of-pocket medical expenses.


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Upcoming changes to HSCO requirements

On January 1, 2014, the health care expenditure rates among all mid- to large-sized businesses in San Francisco are set to change as the new Health Care Security Ordinance (HCSO) goes into effect. The city’s mid-sized businesses (20-99 employees for for-profits and 50-99 for non-profits) will see their employer health care spending requirements increase by eight cents to $1.63 per hour paid. Large businesses (any and all businesses with 100+ employees) will experience an eleven cent increase to $2.44 per hour paid.  Small businesses (0-19 employees for for-profits and 0-49 for non-profits) will remain exempt from the HCSO’s requirements.

Managing the payroll and taxation complexities of the new health care laws

Whenever changes are made to the health care system, tax complications always follow suit. And, it can be hard enough for business owners to keep up with the changes in their health care expenditure obligations let alone dealing with the complex changes in the nation’s taxation laws. Thankfully, managing your business’s employee payroll and tax obligations doesn’t have to be so hard.

Gusto offers professional payroll services that can help you comply with all of the upcoming changes in your business’s tax structure. Businesses in San Francisco will not only have to deal with the changes in the HCSO’s expenditure requirements but also with the new tax laws included in the Affordable Care Act. But don’t worry, Gusto is here and we’re ready to make life easier for you.

About Steve Johnsen

Steve has been in the payroll industry for over 10 years, and currently leads a passionate Customer Care team in Gusto's Denver office. You can get in touch with Steve here.