Affordable Care Act - Information for HR Professionals, Managers, PI's

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Affordable Care Act: Information for HR Professionals, Department Managers and Principal Investigators


Affordable Care Act (ACA) Impact on Benefits Eligibility:

  • Effective January 1, 2016, UC must provide minimum essential medical coverage to all employees working full time
  • The ACA defines full time as 30 or greater ‘average weekly hours of service’  
  • To comply with this law, UC is changing some of the ‘Initial and Continuing Benefits Eligibility Rules’ under the UC Group Insurance Regulations
  • These changes may result in increased benefits expenses to departments and managers will need to consider this when developing business plans
  • Employees typically excluded from eligibility may become eligible for the Core Benefits package / 2016 Core medical premiums
  • The Core insurance default has been removed – All employees must actively enroll in benefits during their Period of Initial Eligibility (PIE) (There will no longer be a default to Core medical, dental or vision)
  • Once any employee becomes eligible for benefits, eligibility may continue for a longer period of time


Which New Groups of Employees Will Become Eligible for Benefits?

  • Per Diem appointees, student employees, casual/restricted employees, and employees paid solely as ‘By Agreement’ appointed at 75% time or more for 3 months or more and/or who average 30 or more average weekly hours of service following a measurement period will be eligible for the Core benefits package / 2016 Core medical premiums (For administration purposes these appointments will be referred to as Group B)
  • Employees in all other appointment types will continue to be subject to the ‘Initial Eligibility Rules’ as outlined in the Group Insurance Regulations, Supplement No. 2  (For administration purposes these appointments will be referred to as Group A)


How Will continuing Eligibility Be Determined?

  • Measurement for continuing eligibility will happen annually and be based on a 12 month ‘look back’ after an employee has worked at least one full standard measurement period; as a result an employee can remain eligible for benefits for a longer period during employment
  • Employees that are not eligible for Benefits on their date of hire will be measured approximately 1 year after their hire date (Initial Measurement Period) to determine if their ‘average weekly hours of service’ meet the threshold for benefits eligibility
  • Employees who remain active but have periods where not hours are worked longer than four weeks but less than 26 weeks will receive up to 501 hours towards continuing eligibility
  • Employees receiving By Agreement Pay for "hours worked" will have these hours counted towards benefits eligibility


Resources – Learn more about….

BELI Resource Sheet with ACA Compliance

Benefits Eligibility Scenarios (PDF)


Training Presentations – Learn more about….

Episode 1 – Benefits Eligibility
Episode 2 – Appointment Extensions and Job Changes (Revised)