The Health Care Accountability Ordinance (HCAO) applies to most City contractors and tenants (including those at the San Francisco International Airport and the Port of San Francisco). The HCAO requires employers 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.
Effective July 1, 2023, covered employers who make payments to San Francisco General Hospital to satisfy the requirements of the HCAO must pay $6.35 per hour, capped at $254.00 per work week. This rate is adjusted for inflation annually on July 1.
Poster and Forms
HCAO Poster (PDFs) - Must be displayed at each workplace
English Spanish Chinese Filipino
HCAO Employee Know Your Rights
HCAO Voluntary Waiver Form
HCAO Payment Form
HCAO Subcontractor Information Form
- HCAO Subcontractor Information Form - This form must be filled out by the Prime Contractor, who is responsible for the Subcontractor's compliance.
Healthy Airport Ordinance & Mayoral Directive
- Healthy Airport Ordinance (HCAO Amendment for SFO Quality Standards Program Employees)
- Health Plan Requirements for Specified COVID-Related Essential Services Contracts
Legal Authority
The San Francisco Board of Supervisors passed the Health Care Accountability Ordinance in 2001.
Resources
HCAO Minimum Standards and Guidance
- HCAO Minimum Standards and Guidance
Effective January 2023 - HCAO Minimum Standards
Effective January 1, 2024 - HCAO FAQ Common Clarifications, 2023-2024
For questions regarding health plan requirements, contact Max Gara at the Department of Public Health at maxwell.gara@sfdph.org or (415) 554-2621.
- Previous HCAO Minimum Standards for Health Plan Benefits
HCAO Fee Rates
- HCAO Fee Option Rates Over Time(since 2001)
Complete MCO/HCAO Resource packets to download
- MCO-HCAO Packet for City Contractors
- MCO-HCAO Packet for SFO Contractors
- MCO-HCAO Packet for SFO Leases and Concessions
For City Departments
- HCAO Contractor Compliance Declaration Word PDF
- List of Exemptions for the HCAO (PDF)
The following forms may be found on the City's Intranet:
-
MCO Form P-360 Exemption & Waiver
-
HCAO Form P-365 Exemption & Waiver
Contact us
If you have any questions about your rights or responsibilities, contact us: 415-554-7903 or email hcao@sfgov.org.
You can file a complaint if you believe your rights have been violated.