Submit an Employer Annual Reporting Form to OLSE

Employers covered by the Health Care Security Ordinance and/or Fair Chance Ordinance are required to submit the Employer Annual Reporting Form by April 30 each year.

What to do

If you are an employer covered under the Health Care Security Ordinance (HCSO) or Fair Chance Ordinance (FCO), you must meet some obligations. One of the obligations is to submit an Annual Reporting Form to the OLSE.

The 2021 Annual Reporting Form (ARF) was due May 2, 2022. It takes about 20 minutes to complete the form. 

The link to the online form is no longer available. You may need to pay penalties if you did not submit your form by the deadline. 

Special cases

Self-funded employers

Self-funded employers

If you used self-funded medical, dental and/or vision plans in 2021, you must calculate the actual value of your plans and make top-off payments to your employees, if needed.

Complete this by February 28, 2022.

Self-funded calculation Instructions and sample letter to Employees for 2021

2022 Health Care Expenditure Rates

2022 Health Care Expenditure Rates

As of January 1, 2022, the required Health Care Expenditure Rates are:

  • $3.30 per hour for large businesses (100+ employees)
  • $2.20 per hour for medium-sized businesses (20-99 employees) 

Telework during Health Order Restrictions

Telework during Health Order Restrictions

The San Francisco Board of Supervisors passed an amendment to the Health Care Security Ordinance (HCSO) on June 22, 2021.

This means that you will get health care coverage if you work remotely while City health orders place restrictions on onsite work.

Get help

Phone

Health Care Security Ordinance

Fair Chance Ordinance

Last updated November 4, 2022