Am I eligible for San Francisco HCSO (SF MRA) payments?

Last updated: October 28, 2026

Applies to: US W-2 employees who work in San Francisco. HCSO payments are a San Francisco requirement for employees who work in the city, so they do not apply to independent contractors or to employees who work anywhere else.

Summary: If you are a W-2 employee who works in San Francisco an average of at least 8 hours a week, you become eligible for San Francisco Health Care Security Ordinance (HCSO) payments on the first day of the month after you complete 90 days of employment. Ascen then makes the payments to the SF City Option for you once a quarter, and you do not need to do anything. The exception: if you signed the San Francisco Healthcare Security Ordinance Employee Waiver during onboarding, you opted out of these payments. You can change that going forward.

What HCSO payments are

You may see these called SF HCSO, HCSO health care expenditures, SF MRA or SF City Option. They are payments Ascen makes on your behalf to the SF City Option because you work in San Francisco.

When you become eligible

You become eligible when both of these are true:

  • You work in San Francisco an average of at least 8 hours a week.

  • You have reached the first day of the month after you complete 90 days of employment. Eligibility does not start on day 90 itself; it starts on the 1st of the next month.

For example, if you started on July 20, you complete 90 days of employment in mid-October, so you become eligible on November 1.

If your hours in San Francisco vary, or you work in the city only occasionally, email support@ascen.com to confirm whether you qualify.

When the payments are made

Ascen makes the payments to the SF City Option once a quarter, after the quarter ends. Your first payment is made after the end of the quarter your eligibility starts in.

Continuing the example: eligibility that starts on November 1 falls in the October to December quarter, so your first payment is made in January.

What you need to do

Nothing. You do not need to sign up or send anything to get set up. Once the first payment has been made on your behalf, we will send you a notice.

If you signed the HCSO waiver during onboarding

During onboarding you may have been shown a form called San Francisco Healthcare Security Ordinance Employee Waiver. If you signed it, you chose to opt out of HCSO payments.

  • To check what you signed: log in to your Ascen account. Documents you sign during onboarding are saved to your account, where you can view and download them. See Where to find your documents.

  • To change your choice going forward: email support@ascen.com and ask to update your San Francisco HCSO waiver. We will send the form back to you so you can complete a new version.

Where to get help

For questions about your eligibility, your dates, the notice, or the waiver, email support@ascen.com.

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