HR Alert

San Francisco: HCSO Waiver Form Recently Updated

Employees Who Have Health Benefits Through Another Employer May Sign the Waiver

The San Francisco Office of Labor Standards Enforcement (OLSE) has published a new Health Care Security Ordinance (HCSO) Employee Voluntary Waiver Form.

New HSCO Waiver Form
To verify that that an employee is receiving health care through another employer and to obtain a voluntary written waiver of the health care expenditure requirements, the following conditions must be satisfied:

  • Employers may not alter the waiver in any manner, nor may employers use other forms, including those provided by third-party vendors or health insurance carriers.
  • The waiver must be voluntarily completed in full by the employee without pressure or coercion from the employee's coworkers or the employer, including, supervisor(s), manager(s), or their agents.
  • The employee must complete the section of the waiver pertaining to the health care services received through another employer. If the employee fails to state on the form that he or she is receiving benefits through another employer or leaves that section blank, the waiver is not valid. Coverage purchased by the employee for him or herself or that the employee is receiving through Medi-Cal or a county health program, does not constitute "benefits received through another employer." A waiver form that states the employee only has such coverage is not a valid waiver.
  • A waiver form is valid for one year (after which the employee may choose to sign a new voluntary waiver). Employees may choose the date on which the one-year waiver period starts, as long as that date is after the date the waiver is signed and within 4 months of the date of signing.
  • Employees may revoke their voluntary waiver at any time. The revocation must be in writing and be submitted to the employer.
  • Employers must provide the employee with a complete copy of the signed waiver.

Click here (section: 3.9) for rules concerning an electronic version of the waiver.

Under the HCSO, covered employers must meet certain obligations, including (among other things) satisfying the employer spending requirement by making required health care expenditures on behalf of covered employees.

Click here for the latest news on San Francisco's HCSO, including expenditure rates and coverage.

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