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

This is a reminder that effective January 2016 new benefits eligibility rules are taking effect for some employees who have historically been excluded from benefits eligibility. New continuing eligibility rules will also be implemented for all employees enrolled in benefits. 

New Initial Eligibility Rules
Employees who have historically been excluded from benefits eligibility can now potentially become eligible for the Core benefits package. This impacts employees listed below (under the “Who is impacted” section) that are either 1) newly hired into an appointment that is at least 75 percent time for 3 or more months or 2)  employees that averaged 30 hours or more worked during an initial or measurement period. 

Who is Impacted

  • Staff employed under "per diem" appointments
  • Academic employees, staff employees, and students employed and paid under a "by agreement" arrangement (recreation instructors; MSP physicians)
  • Students employed under appointment type "casual-restricted" (Hours paid under Federal Work Study programs 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
Employees in the above categories who are eligible for benefits will have a period of initial eligibility (PIE) to enroll in Core benefits starting as early as Jan.1, 2016.

  • The Core default will be turned off starting on Jan 1, 2016—there will no longer be automatic health coverage for all employees newly eligible for benefits if they do not enroll during their PIE.

New Continuing Eligibility Rules
UC is implementing a new method to measure hours for continuing eligibility, which will result in many employees maintaining coverage for a longer period of time.  

Who is Impacted
All employees enrolled in benefits including those who have historically been excluded from eligibility (i.e. per diem employees)

What’s New
Eligibility remains active for at least 12 months once an employee becomes eligible for health benefits coverage.

  • UC will now measure an employee’s average hours of service once a year, in November, over a 12-month "look-back" period, rather than checking this measurement each month
  • "Average Weekly Hours of Service" as defined by the Affordable Care Act (ACA) will be used to determine what hours are used in the calculation:
    • For normally benefitted appointment types, the standard will be 17.5 hours
    • For appointment types previously not eligible for benefits, the standard will be 30 hours
    • If the standard is met, the employee will be offered benefits for the following year
    • If the standard is not met, the employee will not be offered benefits for the following year and their coverage will end on Dec. 31 of that year.
  • The first standard 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 for Department Managers/Supervisors

  • 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

For more details view the What the Affordable Care Act Means For You article on UCnet. 

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.