San Francisco Health Care Security Ordinance Employees (SF HCSO)

The city of San Francisco instituted an ordinance in 2008, referred to as the San Francisco Health Care Security Ordinance (SF HCSO), which requires certain employers to provide health benefits for employees who work within the city or county of San Francisco. To assist employers in meeting the city’s requirements, ASi implements and assists with the ongoing administration of Health Reimbursement Arrangements (HRAs) which provide certain health benefits to eligible employees.

ASi SF HCSO Plans & How to Use Them

As described below, ASi offers two types of HRA plans that are in compliance with the San Francisco Health Care Security Ordinance (SF HCSO).

Excepted Benefits HRA

Unlike other HRAs, the Excepted Benefits HRA does not accompany an employer group health plan.  It’s a limited plan that allows for reimbursements for specific expenses. Please view “What Does My Plan Cover” for more information.

Integrated HRA

An Integrated HRA accompanies your employer’s group heath plan.  An Integrated HRA reimburses eligible medical, prescription, and other healthcare related expenses.  For a detailed list of covered expenses, please visit “What Does My Plan Cover”.

To know which HRA you’re enrolled in, please refer to your quarterly statement, log in to your online account, or contact us.

How To Use My Plan

When you see a provider of service you will pay out-of-pocket for your healthcare expenses.  You will then submit a claim to ASi for expense reimbursement.  There are several ways to submit a claim:

When submitting your claim by email, mail or fax, you must fill out our SF HCSO Reimbursement Form (English | Spanish).

What Type of Documentation Do I Need to Submit with my Claim?

To ensure proper claim processing and payment, proof of service(s) provided must be submitted. The IRS requires the following documentation:

  • Patient Name
  • Provider Name and Address
  • Date of Service (must fall within the plan year), NOT date of payment
  • Service(s) Received or Item(s) Purchased
  • Cost of service or your patient responsibility of the service/item
What Does My Plan Cover?

The following is a general listing of the eligible expenses covered under the Expected Benefits HRA:

  • Dental – Expenses due to the prevention and alleviation of dental disease. Preventive treatment includes the services of a dental hygienist or dentist for such procedures as teeth cleaning, the application of sealants, and fluoride treatments to prevent tooth decay. Treatment to alleviate dental disease include services of a dentist for procedures such as X-rays, fillings, braces, extractions, dentures, and other dental ailments. Anything considered cosmetic is not a covered expense.
  • Vision – Expenses for treatment of the eye (i.e. prescription glasses, contacts, exams, office visits, etc.)
  • Long-term care benefits
  • Nursing home, Home health, Community-based care
  • Coverage limited to a specific disease or illness

The following is a general list of eligible expenses under the Integrated HRA.  For a complete list, please visit the IRS Code Section 213(d).  To view or print the document of ASi’s general list of eligible expenses, please review our Integrated HRA Qualifying Expenses PDF (English | Spanish).

  • Preventative Fees
  • Diagnostic Fees (x-rays, blood tests, lab tests, exams)
  • Prescription Fees (including insulin treatments and some OTC medications)
  • Prenatal and Postnatal Care
  • Hospital Care
  • Specialist Care (Chiropractic, Gynecology, Neurology, Podiatry, Physical Therapist, Surgeons, etc.)
  • Mental Health
  • Vision Expenses
  • Dental Expenses

Whose Expenses are Eligible?

Your HRA plan covers you, your spouse, and any taxable dependents.

How Can I View My Funds?

You have 24/7 access to your view your account balances and details!

Still Have Questions?

Check out our FAQs or contact us!