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San Francisco Healthcare Security Ordinance

The San Francisco Health Care Security Ordinance (HCSO) requires Covered Employers, like USF, to satisfy an Employer Spending Requirement by making health care contribution for their Covered Employees when they meet the HSCO eligibility criteria.

If I’m eligible for a contribution, where does USF make the health care contribution?

As a USF employee, if you work in San Francisco, and do not have employer-provided medical coverage as part of your position you will receive a health care contribution to the HCSO Reimbursement Plan and City Option when you meet the eligibility criteria in the HCSO. To waive the University from making this contribution please see "How to Waive Coverage" section below.

HCSO Reimbursement Plan

Eligible contributions are remitted to the HCSO Reimbursement Plan for a covered employee. This benefit is administered by Custom Benefit Administrators, Inc. (CBA). This plan is a Limited Purpose - or excepted benefit – Health Reimbursement Account (HRA) plan, which limits eligible expense reimbursements to such as the following:

  • Dental benefits limited to treatment of the mouth
  • Vision benefits limited to treatment of the eye
  • Long-term, nursing home, home health, or community-based care premiums

Please refer to the helpful links below for more information:

City Option

Eligible contributions are remitted to the City Option for a covered employee and each contribution is applied towards one of two programs for each employee.

HCSO_City Option Programs


There are two plans. Which plan will receive USF’s contribution?

Effective with 2015 Plan Year contributions, 40% of your employer’s total health care spending requirement earned each quarter will be directed to the HCSO Reimbursement Plan. The remaining 60% will be directed to the City Option.

How will I know if USF has made a contribution?

For HCSO Reimbursement Plan contributions, CBA will send an email to your USF email address and for the City Option you will receive a payment confirmation email to your USF email address followed by an enrollment letter sent by the City Option to your home mailing address. The enrollment letter will provide information about how to apply for Healthy San Francisco, or instructions on how to access your Medical Reimbursement Account (MRA). When you receive the enrollment letter please respond to it immediately. For more information about the City Option program, call (415) 615-4555 or visit the City Option website. 

Where were my contributions remitted to in the 2014 plan year?

In 2014, for hours worked up to 260 hours in a calendar quarter, your contributions were sent to the HCSO Reimbursement Plan administered by CBA. If you worked more than 260 hours during a calendar quarter, the contributions for those excess hours were deposited into the San Francisco City Option.

Where were my contributions remitted to in the 2013 plan year?

In 2013, the University remitted health care contributions to a stand-alone Health Reimbursement Account (HRA). Participants can submit eligible medical-related expenses for reimbursement from contributions remitted by the University. If you have funds remaining in your HRA from 2013 contributions, you may continue to use those funds for eligible medical expenses until the funds forfeit. This plan is administered by CBA.

Click here for guidelines and information about the terms and conditions of the HRA plan.

How to Waive Coverage

Employees who have employer-provided health coverage as either an employee of another company or as a dependent of another person (i.e., a parent or spouse/partner), may complete and submit a voluntary waiver. If you only have the USF Student Health Insurance Plan, you are not eligible to waive. By having other coverage and by signing the waiver, USF will not be required to make a health care expenditure on your behalf.

Please submit a waiver form annually via email to Benefits, fax it to (415) 386-1074 or return it to the Office of Human Resources, Lone Mountain Main 339, and receive a credit of 40 Don Dollars.

If you have any questions about the SFHCSO, please email Benefits.