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The Affordable Care Act introduced rules that could affect your employees’ eligibility for health care and when you need to offer it
The ACA mandates that applicable large employers offer health insurance for full-time employees and their dependent children up to age 26. An applicable large employers is a business that employed at least 50 full-time or full-time equivalent employees on business days during the preceding calendar year.
Individuals must have health care coverage that meets the ACA’s minimum value and affordability requirements for each month of the year, or the employer will face a tax penalty.
Health care coverage for employees of applicable large employers in 2017 must meet these requirements:
It’s important to understand how the ACA defines employee status to ensure your business complies with the law:
A full-time employee is “reasonably expected to work at least 30 hours per week.” (PDF) These employees are entitled to employer-provided health insurance.
If your business employs variable hour or seasonal employees, you must offer health care coverage if they average 30 hours per week or more.
Look back over a period of six to 12 months and average the employee’s work hours over that time to evaluate their coverage eligibility.
Once you’ve determined whether the employee is eligible or ineligible for coverage, that status is locked in for the same length of time as the measurement period for the previous year. Changes to the employee’s work hours over this period do not change their eligibility status over the current period, though they will affect the next measurement period.
Depending on how long you set measurement periods, employees could become eligible for coverage at different times during the plan year and after the maximum 90-day new-hire waiting period.
Temporary employees (also called short-term employees) are expected to work less than one year at the time of hiring. If they work more than 30 hours per week and are not considered a seasonal or variable hour employee, they are eligible to receive health insurance coverage.
We break down Affordable Care Act requirements so you don't have toLearn more about the ACA
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