The San Francisco Office of Labor Standards Enforcement (OLSE) has released the 2026 poster for the City and County of San Francisco Health Care Security Ordinance (SFHCSO). All covered employers remain required to post the notice in all workplaces and job sites, or deliver it electronically or by mail to those working remotely in San Francisco, after it becomes available. Covered employers are generally those with 20 or more employees worldwide, at least one of whom works in San Francisco. Employers with fewer than 20 employees worldwide and nonprofit employers with fewer than 50 employees worldwide are exempt.
Covered employers must spend a minimum amount on healthcare for their covered employees, who are employees entitled to be paid minimum wage, have been employed for at least 90 calendar days, perform at least eight hours of work per week within the geographic boundaries of San Francisco, and do not meet exemption criteria (see the Administrative Guide for specific exemptions). The applicable healthcare expenditure rate varies depending on the size of the employer. As of January 1, 2026, the healthcare expenditure rate for large employers with 100 or more employees worldwide increased to $4.11 per hour payable (up from $3.85 per hour in 2025). For medium-sized employers with 20 to 99 employees worldwide and nonprofit employers with 50 to 99 employees worldwide, the expenditure rate rose to $2.74 per hour payable (up from $2.56 per hour payable in 2025).
For a detailed description of how covered employers can satisfy the minimum employer spending requirement, including quarterly or annual payments (depending on plan funding arrangement) to the SF City Option, please review the Administrative Guide mentioned. All covered employers must submit an HCSO Annual Reporting Form to the OLSE by April 30, verifying compliance with the HCSO during the previous calendar year.
View the 2026 SFHCSO poster and access additional SFHCSO information in the Administrative Guide.