Health Care Security Ordinance (HCSO)

The San Francisco Health Care Security Ordinance (HCSO) requires Covered Employers to satisfy an Employer Spending Requirement by making health care expenditures for their Covered Employees, among other reporting and notice requirements.

Please direct any inquiries about the HCSO, including questions about compliance and the Annual Reporting Form, to the San Francisco Office of Labor Standards Enforcement (OLSE) at or (415) 554-7892 Detailed information about the HCSO is on the OLSE website at:

Employers Covered Under the HCSO An Employer is covered under the HCSO if it:

  • Is a for-profit business with 20 or more employees, or a non-profit business with 50 or more employees; and      
  • Has employees who work in San Francisco. Employees Covered Under the HCSO With some exceptions, an Employee is covered by the HCSO if the Employee works for an Employer covered by the HCSO and:      
  • Is entitled to be paid the minimum wage;      
  • Has been employed by the Employer for at least 90 calendar days; and      
  • Works at least 8 hours per week in San Francisco.