6a. 12B Employee Memo Template.docx

DOCX document 34 KB Posted

Attached to
DPH | As-Needed Tech Assistance and Consulting Svc
Solicitation number
SFGOV-0000011976
Issued by
San Francisco County, San Francisco City, California

About this file

This is a template memorandum for employee notification regarding compliance with domestic partner benefit requirements, applicable to businesses operating under state and local non-discrimination mandates. The document serves as a standardized format for employers to communicate their non-discrimination policies and domestic partner benefit provisions to all employees. The memorandum template requires businesses to declare that they do not discriminate based on 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 template instructs employers to list all employee benefits offered equally to employees with spouses and domestic partners, with specific categories including health insurance, dental insurance, vision insurance, retirement plans, bereavement leave, family leave, parental leave, employee assistance programs, relocation and travel benefits, business discounts, credit union access, child care, and various insurance coverages.

The memorandum establishes that domestic partners are defined as couples registered with any state or local government domestic partner registry, encompassing both same-sex and different-sex couples. The template requires that any relationship verification requirements and waiting periods be applied equally to domestic partnerships and marriages, with domestic partner registry certificates accepted as fully equivalent to marriage certificates. This document functions as a compliance tool for contractors and vendors seeking to meet state and local contract opportunity requirements related to employee benefit equity and non-discrimination 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 .