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Get Health Care Security Ordinance Employee Voluntary Waiver Form

EMPLOYEE VOLUNTARY WAIVER FORM Effective 2008 San Francisco law requires your employer to make health care expenditures on your behalf. A health care expenditure is an amount of money paid by your employer to you or to a third party for the purpose of providing you with access to health care services. Employee s Signature Today s Date If you have any questions about your employer s obligations under the Health Care Security Ordinance please call .

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