Affordable Care Act
New ACA Health Plan
High Deductible Health Plan
The new health care plan that the State will offer to those newly eligible under the Affordable Care Act. This would include eligible temps, students or part-time faculty who become newly eligible under the ACA law.
Non-permanent faculty/staff enroll here at the NC State Health Plan Member Portal for the High Deductible Health Plan.
Please read, if you hire staff and faculty at WSSU and wonder how the Affordable Care Act will impact your hires or current employees.
If you hire people at WSSU, consider the following for Affordable Care Act (ACA) compliance:
- Effective January 1, 2015, the ACA requires that anyone working 30 or more hours per week averaged over a 3 month time period be provided with employer-provided health insurance.
- The ACA employer mandate means that we must look at temporary employees, student employees, graduate RA/TA’s, non-tenure track faculty, lecturers…anyone employed and paid by the University. Many of these may not have been eligible in the past, but may be eligible now. Employer-provided health insurance is the State Health Plan's ACA Health Plan, not student health insurance, graduate support plans, etc. The cost to insure an employee on the State's plan can be determined by using the High Deductible Health Plan Rates and Benefit Summary.
- It is important to associate correct FTE (full-time equivalency) to job data in the HR System. The HR Benefits Office will be responsible for monitoring for eligible employees.
- Eligible employees (30 hours per week for 3 months or more) MUST be offered health insurance. If coverage is elected, departments will be charged for the cost of this health insurance unless the position is a benefits-eligible SPA or EPA appointment.
- In 2012, the ACA required that employers report the value for health insurance in Box 12 of the W-2 form. This has no effect on your taxes currently.
- On January 1, 2014, the ACA required that all individuals not covered by an employer health plan enroll in a health insurance plan.
- A health insurance exchange was created by the federal government for the State of North Carolina.
- Staff and faculty can access the health insurance exchange.
- Staff and faculty who want to purchase coverage through the exchange for their dependents may do so, but will not be eligible for the government provided subsidy since NC State offers dependent health coverage through the State Health Plan.
- Dependent health coverage may be more affordable through the exchange as compared to the State Health Plan even without the subsidy. Be sure to fully understand what you may be purchasing as some plans have very high deductibles before the plan will pay for certain things.
STEP 1- Determine Eligibility by looking at work hours and how long the job/assignment/contract will last.
The HR Benefits Office will monitor eligibility and compliance for the ACA for everyone that is paid by the university. In making hiring decisions, you may use the tool below for assistance in determining eligibility for ACA health coverage.
STEP 2 - Understand measurement periods, look back period, stability periods and breaks in service
For all non-benefits eligible employees or temps hired on or after October 1, 2014. Our standard measurement period will be October 1, 2013 - September 30, 2014.
- We will use a 12 month look back period to determine if the temp/employee averaged 30 or more hours per week over the prior 12 month period (measurement period). If the person averaged 30 or more hours per week, health coverage must be offered at the beginning of the 13th month.
- If eligible and the person accepts the health coverage, it must last for at least 12 months (the stability period) regardless of hours worked (or when the employment ends). After this 12 months of coverage, if the person is working less than 30 hours per week, the coverage may be canceled.
For all non-benefits eligible employees or temps hired on or after January 1, 2015
- If hiring for at least 30 hours or more per week AND at least for 3 months or more, health coverage must be offered within the first 30 days of hire and could begin on the first day of the month following the hire date.
- If it cannot be determined if the position will work 30 or more hours per week OR if there is uncertainty as to the length of the assignment, the HR Benefits Office will monitor eligibility on a month to month basis.
Break in Service Rules
| Type of Unpaid Break | Impact on ACA Measurement Period |
|---|---|
| Less than 4 consecutive weeks | 0 hours will be factored in to the average to determine average hours for up to a 3 week maximum |
|
4-26 consecutive week and break DOES NOT EXCEED length of pre-break employment, which includes:
|
Measurement period average will be used for each week during the break to determine average hours.
|
|
4-26 consecutive week and break EXCEEDS length of pre-break employment, which includes:
|
New measurement period starts the first of the month following the return to work or rehire date. |
| More than 26 consecutive weeks | New measurement period starts the first of the month following the return to work or rehire date. |
STEP 3- Look at EXAMPLES to determine how a hiring decision may impact your department budget for ACA health care.
