San Francisco County Municipal Code Art. XV Health Service System

Sec. 16.700. Participation. Sec. 16.701. Eligibility for Employer Contributions. Sec. 16.702. Health Service; Board Composition. Sec. 16.704. Remedying Discrimination Against Employees in Same-Sex Marriages or in Same-Sex Domestic Partnerships.

New Legislation Notice Publisher's Note: This section has been AMENDED by new legislation (Proposition N, adopted 11/8/2022, effective 12/23/2023, oper. conditional (See section 8 of the proposition)). The text of the section will be included below when the new legislation is effective. The following shall be eligible to participate in the Health Service System: (a) City and County employees. (1) All permanent employees of the City and County of San Francisco whose normal work week at the time of inclusion is the system in not less than twenty (20) hours; (2) All regularly scheduled provisional employees of the City and County of San Francisco whose normal work week at the time of inclusion in the system is not less than twenty (20) hours; (3) All other employees of the City and County of San Francisco, including "as needed" employees, who have worked one thousand and forty hours (1040) in any consecutive twelve (12) month period and whose normal work week at the time of inclusion in the system is not less than twenty (20) hours. (b) Elected officials. (c) All members of the following boards and commissions during their time in service to the City and County of San Francisco: Access Appeals Commission Airport Commission Art Commission Asian Art Commission Board of Education Board of Appeals Building Inspection Commission Civil Service Commission Commission on the Environment Commission on the Status of Women Community College District Governing Board Concourse Authority Disability and Aging Services Commission Elections Commission Entertainment Commission Ethics Commission Fine Arts Museums Board of Trustees Fire Commission Film Commission First Five Commission Health Commission Health Service Board Homelessness Oversight Commission

Human Rights Commission Human Services Commission Juvenile Probation Commission Law Library Board of Trustees Library Commission Municipal Transportation Agency Board of Directors Planning Commission Police Commission Port Commission Public Utilities Commission Public Works Commission Recreation and Park Commission Residential Rent Stabilization and Arbitration Board Retiree Health Care Trust Fund Board Retirement Board Sanitation and Streets Commission Sheriff’s Department Oversight Board Small Business Commission Sunshine Ordinance Task Force War Memorial and Performing Arts Center Board of Trustees Youth Commission (d) All officers and employees as determined eligible by the Board of Education of the San Francisco Unified School District. (e) All officers and employees as determined eligible by the Governing Board of the San Francisco Community College District. (f) All officers and employees as determined eligible by the governing bodies of the San Francisco Transportation Authority, San Francisco Parking Authority, San Francisco Redevelopment Agency, Treasure Island Development Authority, San Francisco Superior Court and any other em- ployees as determined eligible by ordinance. (g) All retirees, surviving spouses, surviving domestic partners and resigned employees. For the purposes of this Chapter, resigned employees shall have the same meaning as used in Section A8.425 of the Charter. (h) All dependents of the foregoing categories as they are determined eligible by the appropriate governing body. (Amended by Ord. 67-86, App. 3/7/86; Ord. 289-00, File No. 001549, App. 12/22/2000; Ord. 181-04, File No. 040741, App. 7/22/2004; Ord. 46-15 , File No. 131122, App. 4/17/2015, Eff. 5/17/2015; Ord. 11-22, File No. 211100, App. 2/4/2022, Eff. 3/7/2022; Ord. 41-23, File No. 230057, App. 3/28/2023, Eff. 4/28/2023)

The following shall be eligible to receive contributions for participation in the Health Service System as set forth below: (a) Members of boards and commissions referenced above in Section 16.700(c) and retirees, surviving spouse and domestic partners referenced above in Section 16.700(g), shall receive only the Charter-determined contribution. Members of boards and commissions who were in service on the effective date of this ordinance shall maintain the same types of benefits during their term of service. (i) Except as may otherwise be required under state or federal law, the surviving spouse or surviving domestic partner of an active employee who is killed in the performance of his or her duty shall continue to receive health benefits under the same terms and conditions provided to the employee prior to the death, or prior to the accident or injury that caused the death. (b) Employees referenced above in Section 16.700(a), elected officials referenced above in Section 16.700(b), members of the San Francisco Unified School District referenced above in Section 16.700(d) and members of the San Francisco Community College District referenced above in Section 16.700(e) shall receive both the Charter-determined contribution and collectively bargained contributions. Notwithstanding the foregoing, employees referenced above in Section 16.700(a), who are not in active service for more than twelve (12) weeks, shall be required to pay the Health Service System for the full premium cost of membership in the Health Service System, unless the employee shall be on sick leave, workers' compensation, mandatory administrative leave, approved personal leave following

family care leave, disciplinary suspensions or on a layoff holdover list where the employee verifies they have no alternative coverage. In accordance with the City's obligations under the Meyers-Milias-Brown Act, the Department of Human Resources shall establish rules and regulations governing whether employees who, after inclusion in the system, work less than twenty (20) hours per week, shall lose eligibility in the system or whether the employee shall be required to make additional contributions to the system. (c) Dependents of employees referenced above in Section 16.700(a) shall only receive collectively bargained contributions. Dependents of elected officials references above in Section 16.700(b) shall only receive contributions specified by ordinance. Dependents of members referenced above in Sections 16.700(d), (e) and (f) shall only receive the contributions specified by the appropriate governing body. Dependents of board and commission members referenced above in Section 16.700(c) shall receive no contribution. Dependents of retired employees referenced above in Section 16.700(g) shall receive contributions only as provided by the Charter. (d) Resigned employees referenced above in Section 16.700(g) shall not receive any contribution. (e) Those subgroups referenced above in Section 16.700(f) shall receive contributions as determined by their respective employers. (Added by Ord. 48-95, App. 3/10/95; amended by Ord. 289-00, File No. 001549, App. 12/22/2000)

In any election for membership on the Health Service Board when only one candidate has filed nomination papers and no person has filed a declaration of write-in candidacy, the Director of Elections shall not conduct an election and shall declare the sole candidate to be a member of the Board. (Added by Ord. 439-96, App. 11/8/96)

(Formerly Sec. 16.157; amended by Ord. 141-86, App. 4/25/86; Ord. 146-87, App. 5/8/87; Ord. 187-88, App. 5/5/88; Ord. 155-89, App. 5/19/89; Ord. 157-90, App. 5/7/90; Ord. 236-91, App. 6/21/91; Ord. 173-92, App. 6/16/92; Ord. 99-93, App. 4/13/93; Ord. 140-94, App. 4/5/94; Ord. 166-95, App. 5/19/95; Ord. 140-96, App. 4/10/96; Ord. 195-97, App. 5/16/97; Ord. 229-98, App. 7/2/98; Ord. 179-99, File No. 990916, App. 6/25/99; Ord. 124-00, File No. 000735, App. 6/2/2000; renumbered by Ord. 289-00, File No. 001549, App. 12/22/2000; amended by Ord. 110-01, File No. 010454, App. 5/18/2001; Ord. 65-02, File No. 020390, App. 5/10/2002; Ord. 70-03, File No. 030415, App. 4/18/2003; Ord. 67-04, File No. 040219, App. 4/22/2004; Ord. 72-05, File No. 050416, App. 4/27/2005; Ord. 35-06, File No. 060087, App. 3/10/2006; Ord. 44-07, File No. 070117, App. 3/9/2007; Ord. 56-08, File No. 080274, App. 4/10/2008; Ord. 35-09, File No. 090097, App. 3/9/2009; Ord. 52-10, File No. 100134, App. 3/19/2010; Ord. 29-11, File No. 110069, App. 3/7/2011; Ord. 39-12 , File No. 120050, App. 2/21/2012, Eff. 3/22/2012; Ord. 181-12 , File No. 120754, App. 8/7/2012, Eff. 9/6/2012; Ord. 190-13 , File No. 130653, App. 8/7/2013, Eff. 9/6/2013, Ord. 174-14 , File No. 140703, App. 7/31/2014, Eff. 8/30/2014; Ord. 132-15 , File No. 150645, App. 7/30/2015, Eff. 8/29/2015; repealed by Ord. 176-16 , File No. 160747, App. 8/11/2016, Eff. 9/10/2016)

IN SAME-SEX DOMESTIC PARTNERSHIPS. (a) Findings and Purpose. The City and County of San Francisco (City) finds that its own employees with same-sex spouses or same-sex domestic partners suffer both dignitary and economic harm as a result of discriminatory federal laws. In particular, as a result of discriminatory treatment under federal tax laws that impose taxes on health care coverage provided to employees with same-sex, but not those with opposite-sex, spouses, City employees with same-sex spouses or same-sex domestic partners suffer not only the indignities of being treated as second-class citizens by their own government; they also suffer measurable financial harm that is concrete, persistent, and significant, and in some cases immense. The City is committed to the equitable principle that all City employees receive equal pay for equal work. That principle is unattainable for City employees with same-sex spouses or same-sex domestic partners so long as: (1) state law prevents same-sex couples from marrying; (2) federal law treats the value of employer contributions for same-sex spouses' or same-sex domestic partners' health insurance premiums as taxable income, and does not tax employer subsidies for opposite-sex spouses' health insurance premiums; and (3) federal law prevents the use of pre-tax dollars by employees to pay health insurance premiums for their same-sex spouses or same-sex domestic partners, while allowing the use of pre-tax dollars by employees to pay health insurance premiums for their opposite- sex spouses. In an effort to offset the discriminatory impact of federal taxation on same-sex spouse and same sex-domestic partner health insurance premiums, and to come closer to achieving the equitable principle of equal pay for equal work, this Section 16.704 requires the City to make payments to City employees who are provided subsidies for, and/or who pay all or part of the premiums for, their same-sex spouses' or same-sex domestic partners' health insurance premiums. (b) For each City employee Health Service System member who is subject to federal taxation on health insurance premiums (both medical and dental) paid by the City for a same-sex spouse, or same-sex domestic partner, the City shall pay an amount equal to twenty

(20%) percent of the portion of the employee's health insurance premiums attributable to the same-sex spouse, or same-sex partner, as determined by the San Francisco Health Service System. These payments shall not be part of the employee's base pay, are not payments made as compensation for hours of employment, and shall not be included in any overtime or premium pay calculations. (c) Operative Date. This Section 16.704 shall become operative on July 1, 2013. (d) Expiration. This Section 16.704 shall expire in its entirety, or as applied specifically to one or more of the following three groups of City employees – employees with same-sex spouses who married in California; employees with same-sex spouses who married outside of California; and employees with same-sex domestic partners – if, and when, the City Attorney's Office certifies to the Mayor and the Board of Supervisors that one or more of those groups of City employees are no longer subject to discriminatory federal income taxation of health insurance premiums attributable to their same-sex spouses or same-sex domestic partners. This Ordinance shall continue to apply to those groups of City employees listed above who continue to be subject to discriminatory federal income tax on health insurance premiums attributable to their same-sex spouses or same-sex domestic partners. (Added by Ord. 34-13, File No. 121124, App. 3/12/2013, Eff. 4/11/2013, Oper. 7/1/2013)