Section O: HCSO and the Affordable Care Act (HCSO Administrative Guidance)

Answers from the HCSO and the Affordable Care Act section of the HCSO Administrative Guidance.

The Affordable Care Act (ACA) is a federal statute that went into effect in 2014. Here are the most common questions OLSE gets regarding the ACA’s impact on the San Francisco Health Care Security Ordinance.

Questions from Employers

1. Does the ACA affect my ability to contribute to the SF City Option as a means of complying with the Employer Spending Requirement?

No.  You can continue to contribute to the SF City Option as a means of complying with the Employer Spending Requirement, just as before. See Section G for more information.

Updated January 3, 2023

Questions from Employees

1. Do the benefits provided by my employer under the HCSO satisfy my obligations to have “minimum essential health coverage” under the ACA?

That depends on what benefits your employer provides.  Employer-sponsored medical insurance generally constitutes minimum essential coverage and satisfies your individual responsibility under the ACA.

The following benefits do not satisfy your obligation to have “minimum essential coverage” under the ACA:

  • the SF City Option
  • excepted benefits Health Reimbursement Accounts (HRAs) –employer-sponsored accounts that reimburse you for your out-of-pocket costs for a limited range of expenses, including vision and dental expenses. (See Section O, Question 3(b) for more information);
  • dental insurance; and
  • vision insurance.

If your employer only provides you with the types of benefits above that do not constitute minimum essential coverage, you still need to get coverage elsewhere that satisfies the requirements of the ACA (or pay the penalty).

2. Where can I get more information about obtaining affordable health insurance for myself and/or my family?

For more information, please check the following resources: 

Updated January 3, 2023

Last updated October 19, 2023