SF Essentials Group Plan Solution FAQ

General FAQ's Regarding SF Essentials Group Plan Solution

What is SF Essentials?

SF Essentials is a benefit plan developed by Apex, Beazley and ASi to assist companies within the SF City limits comply with the San Francisco Health Care Security Ordinance (SFHCSO).

What is the PPACA?

The Patient Protection and Affordable Care Act, also known as PPACA, healthcare reform, Obamacare, Affordable Care Act or the ACA, is a law enacted on March 23, 2010, which issued new rules and guidelines on the offering, administration, and acceptance of healthcare coverage in the United States.

What is the SFHCSO?

The San Francisco Health Care Security Ordinance (SFHCSO) requires employers who employ 20 or more employees nationwide, to satisfy the Employer Spending Requirement (ESR), by making the required healthcare expenditures on behalf of all covered employees; maintain records to establish compliance with the ESR; and submit an Annual Reporting Form by April 30th of each year.  

For Further details in see the Broker Document - SF Essentials Overview.

How many employer sizes are considered by the SFHCSO?

There are 3 employer sizes:

  • Small – Nonprofits 0-49 EEs / Businesses 0-19 EEs
  • Medium - Nonprofits 50-99 EEs / Businesses 20-99 EEs
  • Large – All employers 100+ EEs

What are the 2019 expenditure rates for the SFHSCO?

The SFHSCO employer expenditure rates for 2019 are - 

  • For Medium Size Employers - $1.95 per hour payable
  • For Large Size Employers- $2.93 per hour payable

What are the rates for each plan?

SF Essentials #1 for medium size groups –

  • $154.44 Per Employee Per Month.

 

SF Essentials #2 for large size groups

  • $255.56 Per Employee Per Month.

How many SFHCSO plan options are there?

There are 2 available plan options.

  • Medium size groups have the SF Essentials #1 option.
  • Large size groups have the SF Essential #2 option.

Who are the participating provider organizations on the SF Essentials plan?

The participating provider list includes –

  • Apex Management Group  – Compliant MEC provider
  • PHCS Network – over 900,000 health care providers
  • WellDyne PBM –  65,000 pharmacies available nationwide
  • Teladoc – Free and unlimited
  • RCI and ASi – Third Party Administrators
  • Beazley Insurance Company, Inc. –  A Specialist Insurer

How can I get a quote?

Call 602-395-8900.