Health Care Reform
In 2010, the federal government enacted a comprehensive law to reform the health care system, called the Patient Protection and Affordable Care Act (ACA). The purpose of the law is to increase access to affordable health insurance. The ACA requires certain businesses to offer qualifying health care coverage to employees or pay a penalty, and to comply with notice and reporting provisions.
Employers with employees working in San Francisco should determine whether they are subject to both the ACA and the San Francisco Health Care Security Ordinance (HCSO), only the HCSO, or neither the ACA nor the HCSO. Employers subject to both the ACA and the HCSO need to comply with the requirements of both laws. Compliance with the ACA does not necessarily ensure compliance with the HCSO, and vice versa.
The San Francisco Office of Labor Standards Enforcement (OLSE) has published answers to some frequently asked questions about the impact of the ACA on the HCSO. Click here to read FAQs on the HCSO and ACA.
The following table compares the HCSO and ACA:
|Health Care Security Ordinance (HCSO)||Affordable Care Act
|Scope||San Francisco law||Federal law|
|Effective Date||January 9, 2008||January 1, 2015 for employer enforcement and reporting provisions|
|Covered Employers – Employer Size||Businesses with 50+ full-time (FT) and/or full-time equivalent (FTE) employees|
|Covered Employees – Hours Worked||Employee works an average of 8 hours per week in San Francisco||Employee works an average of 30 hours per week|
|Options to Comply||
|Requirements for Health Care Coverage||As stated under Section 14.1(9) of the San Francisco Administrative Code: “Medical care, services, or goods that may qualify as tax deductible medical care expenses under Section 213 of the Internal Revenue Code, or medical care, services, or goods having substantially the same purpose or effect as such deductible expenses”||
|Enforcement Agency||San Francisco Office of Labor Standards Enforcement (OLSE)||US Internal Revenue Service (IRS)|
|Notice||Post Official HCSO Notice at every workplace where a Covered Employee works||Provide notice of Covered California health insurance marketplace to Employees|
|Reporting||Submit HCSO Annual Reporting Form to OLSE by April 30 annually||File employee health care coverage information with IRS annually as required by IRS Code Section 6056|