Affordable Care Act (ACA)

Eligibility for Benefits for Employees Under the ACA

Variable-Hour, Part-Time, and Seasonal Employees

  • New Employees: If you are a new variable-hour, part-time, or seasonal employee and your employer cannot determine whether you will average 30 hours per week in your first 12 months of employment, you cannot immediately enroll in benefits.

  • Measurement Period: Your employer must track your work hours over the first 12 months after you are hired, beginning the first day of the month following your hire date

    • If, during this measurement period, you average 30 hours per week, you will become eligible for benefits for the following 12-month period.

    • If you average fewer than 30 hours per week, you will not be eligible for benefits unless your employer determines your eligibility by another method.

Ongoing Employees

  • Measurement of Hours: For employees who have worked for their employer from October 4 to October 3, your employer will assess your work hours during this 12-month period.

    • If you worked an average of 30 hours per week during this period, you are eligible for benefits during the following year (2018), even if your hours decrease during 2018.

    • If you worked an average of fewer than 30 hours per week, you will not be eligible for coverage, unless you qualify under a different provision of your employer’s benefits plan.

Benefits Eligibility

Employees and their eligible dependents who meet the criteria above may enroll in the following benefits:

  • Health Insurance:

    • State Health Plan (Savings Plan and Standard Plan)

    • TRICARE Supplement Plan (for eligible military members).

  • Health Savings Account (HSA): Available for employees enrolled in the Savings Plan.

  • Dental Plans:

    • State Dental Plan

    • Dental Plus

  • Vision Plan: State Vision Plan

  • Life insurance:

    • Basic Life Insurance

    • Optional and Dependent Life Insurance

  • Long-Term Disability Insurance:

    • Basic and Supplemental Long-Term Disability Insurance

  • Flexible Spending Accounts (FSA):

    • Dependent Care Spending Account

    • Medical Spending Account or Limited-use Medical Spending Account

     

Questions?

If you have questions about how the Affordable Care Act affects your eligibility for benefits, please contact your benefits administrator.

For more details about benefits options for permanent, non-permanent, seasonal, and variable-hour employees who lose coverage, please refer to the General Information chapter of the Insurance Benefits Guide.