Under the Affordable Care Act (ACA) new benefits eligibility rules are taking effect in January 2016 for all employees who have historically been excluded from benefits eligibility.

The new rules require all employees averaging 30 hours/week during a full standard measurement period be given an offer of at least CORE benefits and coverage. If elected benefits will continue during a full 12-month stability period.

Who is Impacted
The following employment arrangements, which are currently excluded from the faculty and staff benefits program under current rules, will be impacted:

  • Staff in "per diem" appointments
  • Academic and staff employees and students employed and paid under a "by agreement" arrangement (recreation instructors; MSP physicians)
  • Students under appointment type "casual-restricted"
    • Hours paid under the Federal Work-Study Program are not counted in the 30 hours/week average calculation
  • Graduate student employees with cumulative appointments that average 75 percent time or greater

What’s New
Eligible employees in the above categories averaging 30 hours/week during a full standard measurement period:

  • Will have a period of initial eligibility (PIE) to enroll in CORE benefits starting as early as Jan. 1, 2016
  • If CORE is elected, coverage will continue through the 2016 calendar year if the employee remains employed at UC

The first measurement period is already underway:

  • Nov. 1, 2014, through Oct. 31, 2015, for monthly paid employees
  • Nov. 9, 2014, through Nov. 7, 2015, for employees paid biweekly

Considerations

  • These changes may result in an increase in benefits costs to your department
    • When making your business plan keep in mind that going forward benefits eligibility for your employees may continue for a longer period of time
    • When appointing per diem employees and/or student employees keep in mind these employees may initially or potentially become eligible for CORE benefits starting as early as Jan. 1, 2016
  • The CORE default will be turned off starting on Jan. 1, 2016, so if no enrollment action is taken during a PIE there will no longer be automatic health coverage

This article is intended to be informational; departments do not need to take any action at this time.

Stay tuned to HR Update for more information as it becomes available and please partner with your HR Generalist and Benefits Office if you have any questions.