The Health Care Security Ordinance (HCSO) requires covered employers to make health care expenditures (HCEs) for their covered employees. Covered employers can make HCEs in a variety of ways, such as purchasing health insurance coverage for their covered employees. Another option is to make payments to the city on behalf of covered employees to establish their eligibility in a Health Access Program run by Department of Public Health (the “City Option”). The City Option includes Healthy San Francisco and two Medical Reimbursement Accounts (MRA).

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