6a. 12B Employee Memo Template.docx

DOCX document 32 KB Posted

Attached to
DPH | RFQ As-Needed Community Outreach and Media S
Solicitation number
SFGOV-0000011970
Issued by
San Francisco County, California

About this file

This document is a template memorandum for businesses to communicate their compliance with California's Domestic Partner Benefit Policy (12B) to employees. The memorandum is designed for use by any business operating in California and serves as a standardized format for notifying employees of non-discriminatory employment practices. The template addresses protected categories including race, color, creed, religion, national origin, ancestry, age, sex, sexual orientation, gender identity, domestic partner status, marital status, disability, AIDS/HIV status, height, and weight. The memorandum requires businesses to itemize all employee benefits provided equally to married employees and employees with domestic partners, including health insurance, dental insurance, vision insurance, retirement plans, bereavement leave, family leave, parental leave, employee assistance programs, relocation and travel assistance, business discounts, credit union access, child care, and various insurance coverage options.

The template establishes that domestic partners are defined as couples registered with any state or local government domestic partner registry, applying equally to same-sex and different-sex couples. The memorandum requires that proof of relationship requirements and waiting periods be applied uniformly to both domestic partnerships and marriages, with domestic partner registry certificates treated as equivalent to marriage certificates. This template ensures organizational compliance with California's requirements for equal treatment of domestic partners in employee benefit distribution and serves as documentation of the employer's commitment to non-discriminatory employment policies.

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Text version

EXAMPLE OF 12B COMPLIANT MEMORANDUM TO EMPLOYEES

[DELETE THE LINE ABOVE AND PRINT ON YOUR BUSINESS LETTERHEAD]

To:All [Business Name] Employees
From:[Business Representative Name, Title] Re:Domestic Partner Benefit Policy
Date:[Date]

[Business Name] does not discriminate based on the following protected categories:

Race, Color, Creed, Religion, National origin, Ancestry, Age, Sex, Sexual Orientation, Gender identity (transgender status), Domestic Partner status, Marital status, Disability, AIDS/HIV status, Height, Weight

[Business Name] offers the following employee benefits equally to employees with spouses and employees with domestic partners, and to the spouses and domestic partners of such employees [List all benefits provided by business and delete all other benefits]:

· Health Insurance - [List each carrier]

· Dental Insurance - [List each carrier]

· Vison Insurance - [List each carrier]

· Retirement - [List each type of plan, for example, Pension, 401(k), 403(b), Simple IRA]

· Bereavement Leave

· Family Leave

· Parental Leave

· Employee Assistance Program

· Relocation and/or Travel

· Business Discount, Facilities & Events

· Credit Union

· Child Care

· Dependent Life Insurance - [List each carrier]

· Short Term and/or Long-Term Disability Insurance - [List each carrier]

· Accidental Death & Dismemberment Insurance – [List each carrier]

Domestic partners are defined as couples who are registered with any state or local government domestic partner registry. This applies to both same-sex and different-sex couples. Any requirements for proof of relationship and waiting periods are applied equally to domestic partnerships and marriages. Domestic partner registry certificates are accepted as fully equivalent to marriage certificates.

(08-21)

File details come from the government source that posted it. Updated .