Select Page

San Francisco Health Care Security Ordinance

California recently expanded its definition of domestic partnership for purposes of registering with the state to receive the same state protections offered to spouses, including eligibility under fully insured employer-sponsored health plans. California’s new law opens the registration process by expanding the number of opposite-sex domestic partnerships eligible to register.

Registration of domestic partnerships has long been broadly offered to same-sex partnerships but has been limited for opposite-sex partnerships to those where one or both partners were over age 62.

Effective Jan. 1, 2020, California removed the age restriction imposed on registration of opposite-sex domestic partners. Under the revised law, domestic partners, regardless of sex, may file a Declaration of Domestic Partnership with the state of California if they have chosen to share one another’s lives in an intimate and committed relationship of mutual caring and meet the following criteria:

  • Neither person is currently married or a member of another domestic partnership.
  • They are not related by blood such that it would prevent them from being married to each other.
  • Both individuals are at least 18 years of age.
  • Both individuals are capable of consenting to the domestic partnership.

For purposes of eligibility, fully insured health policies subject to California insurance mandates treat California-registered domestic partners like spouses. With more opposite-sex domestic partners offered the opportunity to register, employers may find their insured group plans subject to covering more opposite-sex domestic partners residing in California.

Lockton comment: Given the requirement to register domestic partnerships to gain state protections, employers may not experience an immediate impact on health plan enrollment. However, there may be greater impact to enrollment in future years as opposite-sex partners take advantage of California’s legal protections offered by registering their relationships.

Once the state has updated the registration process, employers holding fully insured group medical insurance contracts should expect to receive guidance from their medical insurers relating to domestic partner coverage consistent with the removal of the age restrictions on registering opposite-sex domestic partnerships. It is likely insurance contracts issued or renewed after 2019 will be updated to reflect eligibility for registered opposite-sex domestic partners without age restrictions.


San Francisco updates Health Care Security Ordinance contribution rates and other limits for 2020

San Francisco requires all but the smallest employers to make healthcare expenditures on behalf of employees working in San Francisco county, subject to a handful of exceptions. The required employer expenditures are expressed as a dollar amount per hour worked.

For 2020, the per-hour healthcare expenditure rate for San Francisco employees working for employers with at least 100 employees (regardless of location) is $3.08, up from $2.93 last year. For employers with 20-99 employees, the 2020 per-hour expenditure rate is $2.05, up from $1.95 in 2019.

Lockton comment: Specifically defined classes of employees are excluded from the ordinance’s protections, among them managerial, supervisory and confidential employees earning more than a threshold amount. For 2020, employees who fall within those classifications and earn at least $100,796 annually (or at least $50.37 hourly), up from $97,722 (or $48.46 per hour) in 2019, are exempt from the entitlement to employer healthcare expenditures.

Lockton clients interested in learning more about the San Francisco Health Care Security Ordinance might enjoy our Employer Guide to the San Francisco Health Care Security Ordinance, available from your account service team.