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AFFORDABLE CARE ACT/HEALTH CARE REFORM DEPARTMENT TOOLKIT

Benefit Eligibility Rules for ACA

Immediate Eligibility – Employees who are expected to be paid 30 hours/week or more upon hire or if rehired after a greater than 26 week break for 90 continuous days.

  • Temporary and Fixed Term Faculty/Academic employees – Eligibility will be automatic. Eligibility determined by the work percentage and primary assignment end date on hire or change of status form.
  • All other non-benefit-eligible employees* – Eligibility is not automatic. Departments will need to complete Affordable Care Act / Health Care Reform Notification Form for all employees who meet immediate eligibility criteria.

Enrollment

    • Coverage begins the first of the month following date of hire.
    • Eligibility continues until the end of the initial measurement period as long as there is no change in status.

 * On-call, project pay, students and graduate assistants.

Variable Hour Eligibility – Employees who are paid at least 30 hours/week or more during either an initial or standard measurement period.

Enrollment

    • Coverage begins the first of the month after the end of the measurement period.
    • Eligibility continues for 12 months and is evaluated every calendar year

Checklist

  Review ACA Time Report regularly. The ACA Time Report should be launched and reviewed on payday Fridays for the pay period that is being paid.

  Review ACA FAQs regularly for updates to eligibility rules and processes.

  Terminate employees who are not currently working or once their project has been completed.

  • No refunds if retroactive employment changes.
  • Health Fee levied based on employee status as of last day of month.

  Before hiring Project Pay, please review Project Pay policy.

Considerations:

  • If applicable, pay the employee hourly.
    • Once the employee completes a project you may want to terminate the employee.
    • Breaks in service, where there is a status change to zero hours of service for at least five consecutive weeks and less than or equal to 26 weeks, may affect eligibility.
    • Hours will be estimated by dividing the total pay by an average estimated hourly rate for the employee type. Average rates may be updated annually each January. Current rates:
      • $10 per hour for student employees
      • $14 per hour for support staff
      • $50 per hour for faculty/academic staff

  Make sure employees activate their NetID. Human Resources uses msu.edu email account to send messages regarding enrollment.

  Monitor Graduate Assistant and Student eligibility.

  • If Graduate Assistants meet eligibility they will be offered both ACA coverage and Graduate Assistant coverage.
  • Departments will not be charged the ACA fee as long as the Graduate Assistant is covered as part of their Assistantship. At the conclusion of the Assistantship, mandated coverage may be offered for the remainder of the stability period if applicable and there is an on-going employment relationship.
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