Covered Employers are only required to make Health Care Expenditures for their Covered Employees. Which employees are Covered Employees?

An employee is covered by the HCSO if s/he works for a Covered Employer and:

1. Is entitled to be paid the minimum wage;
2. Has been employed by his or her employer for at least 90 calendar days;
3. Performs at least 8 hours of work per week within the geographic boundaries of San Francisco (not just full-time and part-time employees who work 20 or more hours per week need to be covered); and
4. Is not an exempt employee, which includes employees who –
   1. Voluntarily waive their right.
   2. Qualify as managers, supervisors, or confidential employees AND earn more than the applicable salary exemption amount:
      2017 – $95,101 (annual), $45.72 (hourly) (includes commissions and piece rate wages, but does not include overtime wages, gifts, or most bonuses.).
   3. Are covered by Medicare or TRICARE.
   4. Are employed by a non-profit corporation for up to one year as trainees in a bona fide training program consistent with federal law.
   5. Receive health care benefits pursuant to the San Francisco Health Care Accountability Ordinance (HCAO).

Are owners considered Covered Employees under the HCSO?

Although owners who perform work for compensation must be counted for the purpose of determining employer size, owners are not considered Covered Employees because they are not entitled to payment of the minimum wage. Thus, the business is not required to make Health Care Expenditures to or on behalf of the owner(s).

Can employees voluntarily waive their right to have their employers make Health Care Expenditures for their benefit?

Yes, employees can voluntarily waive their right to have their employers make Health Care Expenditures for their benefit if the employee is receiving health care benefits through another employer. Coverage purchased by the employee for him or herself or that the employee is receiving through Medi-Cal or a county health program, is not benefits received through another employer.

The employee must sign the OLSE Employee Voluntary Waiver Form. If the employee fails to state on the form that s/he is receiving benefits through another employer, or leaves that section of the waiver form blank, the waiver form is not valid. The waiver is valid for one year or until revoked by the employee. Employees cannot waive their rights retroactively.

What if the number of hours that an employee works in San Francisco changes over the quarter?

An employee who regularly works eight or more hours per week in San Francisco is covered by the HCSO. For example: an employee who regularly works one eight-hour day per week for the month of January is a covered employee for that month, even if she does not work during the last two months of the quarter.

For employees whose work hours in San Francisco fluctuate, the employer may average the employee’s hours over the 13 weeks in the quarter. Covered Employers are only required to make Health Care Expenditures during those quarters in which the employee works an average of eight or more hours per week in San Francisco.

For an employee who is terminated before the end of the quarter, the employer would calculate the average by dividing the total number of hours worked during that quarter by the number of weeks employed during that quarter.

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