Recently, the 2023 San Francisco Health Care Security Ordinance (SF HCSO) expenditure rates were released, which are increased annually and vary based on employer size.

For 2023, medium-sized covered employers must spend $2.27 per hour payable (up to a maximum of $390.44 per month, based on a maximum of 172 hours payable) and large covered employers must spend $3.40 per hour payable (up to a maximum of $584.80 per month, based on a maximum of 172 hours payable) on their covered employees’ health care. 

The new 2023 rates, as compared to the 2022 rates, are outlined below:

2023 Rates2022 Rates
Small Employers
(0-19 employees) 
Exempt Exempt 
Medium Employer
(20-99 employees) 
$2.27/hour
(max $390.44/month) 
$2.20/hour
(max $378.40/month)
Large Employer
(100+ employees)
$3.40/hour
(max $584.80/month) 
$3.30/hour
(max $567.60/month) 

As a reminder, SF HCSO requires covered employers to spend a minimum amount on covered employees’ healthcare. For more information on who qualifies as a covered employer, which employees are covered by the ordinance, and other employer obligations under the SF HCSO regulations, we recommend employers review the SF HCSO website and accompanying regulations.

Additional Resources

Diane Cross — Diane is a Client Compliance Consultant for Sequoia, where she works with our clients to optimize and streamline benefits compliance. In her free time, Diane enjoys spending time with her family, live music, and cycling.