The Affordable Care Act and Employees
The Affordable Care Act (ACA) and your ºÚÁÏÉçÇø benefits: What you need to know
There are many components to this complex law that affect both individuals and employers including overall expansion of access including the creation of the health care exchanges, expansion of covered preventive services, the individual mandate requiring health care coverage for individuals, health plan value standards and the requirement for large employers to offer coverage.
The following is an overview on how you become eligible for health insurance benefits and other important information.
The ACA requires employers like ºÚÁÏÉçÇø to offer health insurance to all full-time employees. The University already offers health insurance to all benefit-eligible employees.
The ACA also requires employers offer plans that meet certain standards. ºÚÁÏÉçÇøâ€™s medical plan meets these standards including providing minimum essential coverage, allowing dependents to remain covered to age 26, ensuring affordability per the ACA, covering preventive services at 100%, removing annual and lifetime maximums, counting prescription copays and copays toward out-of-pocket maximums, eliminating pre-existing conditions and other requirements.
The ACA required most citizens have insurance effective Jan. 2, 2014. The law allows people to acquire affordable, comprehensive coverage in many different ways including employer provided coverage, coverage from a private insurance company or coverage from the government. People who are not covered may have to pay a tax penalty.
Learn more about the ACA at .
Employees currently enrolled in health insurance coverage do not need to take any action. Under the law, employees must secure the required minimum essential coverage. Current full-time, benefits eligible employees are offered health insurance by the university that this requirement.
As mentioned above, employers must offer health insurance to all eligible full time employees. Eligibility for full-time status for the purposes of health insurance coverage is determined by measurement periods.
A measurement period is a period of time during which the University will look back to see how many hours of service per week employees were credited on average. The University uses that average to determine the eligibility or continued eligibility for health insurance benefits for those employees.
A stability period is a period of time during which an employee will either be considered to be a full-time or non-full-time employee for purposes of for health benefits. An employee that is determined to be full-time during the immediately prior measurement period will be considered a full-time employee eligible for health benefits for the immediately subsequent stability period.
A stability period is a period of time during which an employee will either be considered to be a full-time or non-full-time employee for purposes of for health benefits. An employee that is determined to be full-time during the immediately prior measurement period will be considered a full-time employee eligible for health benefits for the immediately subsequent stability period.
An administrative period is a period of time, between the measurement period and the stability period, during which the University will determine which employees are eligible for coverage. The University will also notify and enroll eligible employees. For ongoing employees, the administrative period occurs after the measurement period ends and before the associated stability period begins.
You are eligible for coverage if:
- You were originally hired as a full-time employee; or
- You are credited with at least 30 hours of service per week during a measurement period. This option is available for employees initially hired in a less than full-time capacity who serve in variable hour, part-time roles (such as adjunct faculty and temporary employees)
No. Employees may waive or decline coverage but should arrange for coverage from another source.
A full-time employee is an employee with at least 130 hours of service per month or an average of 30 hours of service per week. For variable hour employees, the University determines the average number of hours of service per week or per month during a 12-month measuring period. An employee that works on average at least 130 hours per month or 30 hours per week during the measurement period is considered a full-time employee for health insurance coverage eligibility beginning with the next stability period.