Affordable Care Act
The Affordable Care Act (ACA) provides rules that make some employee groups eligible for medical benefits when they had previously been considered ineligible.
Any of the employee groups below working an average of at least 30 hours per week over a 10-month measurement period will be considered a benefits-eligible employee (health, dental, & vision). There are four main groups that ACA affects:
- Temporary employees
- Adjunct faculty/part-time instructors
- Undergraduate and graduate student employees
- Graduate assistants
- Hours worked will be tracked as appropriate to make the final determination of average hours worked over the measurement period.
- If determined to have worked an average of 30 hours per week, the employee will be notified of eligibility of coverage and will have 60 days from the end of the measurement period to enroll. The effective date of coverage will be the day after the end of the 60-day enrollment period.
- To determine the average hours worked for instructors, the following formula will be used to convert adjunct credit hours to equivalent clock hours: Multiply the hours taught by 2.5 and that number by the number of weeks in the term.
- Example: Adjunct teaches 6 credit hours = 6 X 2.5 = 15 hours/week.
- This method allows the hours to be converted to a weekly basis, addressing the issues of different lengths of terms and adjuncts who also have part-time non-exempt positions in addition to the teaching responsibilities.
- If determined to have worked an average of 30 hours per week, the employee will be notified of eligibility of coverage and will have 60 days from the end of the measurement period to enroll. The effective date of coverage will be the day after the end of the 60-day enrollment period.
Undergraduate and graduate student employees
- Hours worked will be tracked to make the final determination of average hours worked over the measurement period.
- If determined to have worked an average of 30 hours per week, the employee will be notified of eligibility of coverage and will have 60 days from the end of the measurement period to enroll. The effective date of coverage will be the day after the end of the 60-day enrollment period.
- The University has a current practice that allows for graduate assistants to work a maximum of 20 hours per week. It is not expected that any exceptions will be made to this practice.
- However, if any exceptions are made and the graduate assistant works an average of 30 hours/week during the measurement period, health insurance coverage will be made available as appropriate.
Measurement Period
To determine if an employee is eligible, an initial 10-month look-back measurement
period will be used to determine the average hours an employee has worked. If an employee
is determined to be eligible, they will have a 60-day enrollment period, with coverage
becoming effective at the end of the 60-day enrollment period. Below is an example
for determining eligibility during the initial measurement period beginning January
2020.
Example: A temporary employee begins working January 2, 2020. At the end of October
2020, it is determined that he has worked an average of 30 hours per week during the
previous 10 months. The employee will be notified of eligibility and have 60 days
to complete enrollment paperwork. If elected, coverage will be effective January 1,
2021.
Stability Period
The stability period is the period of time the insurance coverage is in effect, once
determined eligible by the employer and elected by the employee. The stability period
must be at least as long as the measurement period, or 10 months. As a result, once
an employee is determined eligible and insurance is elected by the employee, employees
will remain eligible until the employing institutions' Department of Human Resources
is notified there has been a significant change in the employee's working hours that
is expected to be in duration at least as long as the measurement period. Example:
Reduction in FTE from 80% time to 50% time, or adjunct only teaching one semester.
In circumstances where the employee no longer meets the eligibility criteria, once
the stability period has been met, the institution may notify the employee coverage
will end at of the end of the stability period. Institutions must be consistent in
application of this procedure. In all cases, the employee must be actively employed
to be eligible for continuation of coverage.