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Affordable Care Act Information

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The purpose of this information is to aid State of Utah employees in the understanding of the Affordable Care Act (ACA), and how it pertains to the State of Utah as an employer. Below, you will find a variety of on-demand tools available for your use.  The ACA guidelines are subject to change, and updates will be made on this site as they become available.

Definitions

Note: definitions contained in this document are as they are defined for purposes of the ACA 

Large Employer
Under The ACA the State of Utah is considered a large employer because it employs 50 or more full-time or full-time equivalent employees. (The employer aggregation rules set forth in Section 414 of the Internal Revenue Code apply).

Safe Harbor Methods
Methods that employers may use, without penalty, to determine whether or not employees are considered FULL TIME and for determining other factors as they relate to The ACA.

Full Time Employee
Under The ACA, a full time employee is one who is paid (not just hours worked) an average of 30 or more hours per week during a 12 month (measurement) period.

Ongoing Employees
Current employees who are employed by the state on May 1, 2014 or before and New Hires after May 1, 2014, who have completed an initial measurement period.  Ongoing employees are those who are employed by the same employer for at least one complete standard measurement period.

Standard Measurement Period
A 12 month period during which the employer tracks the hours of ongoing employees to determine if they worked on average at least 30 hours per week.

New Employee
New to state employment May 2, 2014 or later.

Initial Measurement Period
New employees have an initial measurement period of 12 months where the employee’s hours are tracked to determine if they worked on average at least 30 hours per week.  The initial measurement period begins on the first of the month following the new employee’s hire date.

Frequently Asked Questions

Q. I am a part-time (variable hour) employee at the State of Utah. Do I qualify for health insurance under the ACA?
A. It depends. If you are paid for an average of 30 or more hours per week over a 12 month pre-set (measurement) period, you will be offered health insurance under the ACA for the following 12 month (stability) period. An employee’s work schedule is subject to the approval of agency management.

Q. If I qualify for health insurance under ACA, can I add my family?
A. Spouses may be added to your policy as well as dependents up to age 26 under the ACA.

Q. As a new employee with the State of Utah, when will I know if I qualify for health insurance under the ACA?
A.  It depends:

  • Effective July 1, 2015, if you are hired as a full-time employee as defined by the ACA (30 or more hours on average per week), you will be offered health insurance when hired.
  • Effective May 1, 2014, if you are hired as a variable hour employee, or your work hours are unknown, you will be notified if you qualify after a 12 month measurement period.

Q. As a variable hour employee if I am offered health insurance under the ACA, how long will I be covered?
A. Typically, 12 months (stability period) of coverage follows an offer of health insurance under the ACA (there may be exceptions, so check with your manager.)

Q. What happens if I am offered health insurance under the ACA because I averaged 30 or more hours per week (during the measurement period), but my hours then drop below the required average?
A. You will be covered for 12 months regardless of hours worked during the coverage (stability) period of 12 months.

Q. What happens after my 12 month coverage (stability) period ends?
A. At the same time you are offered coverage, a new 12 month measurement period simultaneously begins in which your hours will be tracked again to determine eligibility for the following 12 month period.

Note: an employee may qualify for coverage one period of time, but not the next, thereby going on and off of health insurance under the ACA.

Q.  If I am receiving health insurance under the ACA and stop working for the State of Utah, will my coverage continue for the remainder of the 12 month period it was offered to me?

A.  If you are no longer working the State, your health insurance coverage ends upon termination.

Q.  When I left my previous employer, I had three months of health insurance under the ACA left.  Will the State continue that coverage for me?

A.  The offer of health insurance under the ACA is employer specific.  Therefore, the State does not have an obligation to continue coverage you were eligible for at another employer.

Q.  If I am eligible and offered health insurance coverage under the ACA, will I also receive retirement and other benefits? 

A.  Under the ACA only health insruance will be offered.

Q.  When will the State start tracking my hours within a 12 month measurement period to determine if I am eligible for the health insurance coverage under ACA?

A.  May 1, 2014 for current employees.  For new employees, hours will start being tracked on the first day of the month following their start date.

Q.  If I am eligible and offered health insurance coverage under the ACA, what plan options will I have?

A.  Plan design for the ACA coverage is currenlty the same as offered to other benefits eligible employees.

Q.  If I am eligible and offered health insurance coverage, how long do I have to enroll in a health plan under the ACA?

A.  Up to 30 days from the date you are eligible for all plan options;  60 days for the STAR Plan and Utah Basic Plus Plan.

Q. Under the ACA, which employees are considered “seasonal” and are these employees treated differently than other variable hour employees?

A. The ACA defines “seasonal” employees as those who are in positions hired for six months or less and occur about the same time each year.

DHRM will track “seasonal employee” hours because if the “seasonal” goes beyond the definition and/or transfers to a variable hour position during or after the measurement period, those previous hours may need to be counted and an offer of coverage may be offered.

Q. Since I have worked for the state in the past, do the hours I worked before count toward my total hours now that I work for the state again?

A. An employee’s previous hours will not count if his/her break in service is:

  • ≥ 13 consecutive weeks; 26 consecutive weeks for the Utah School Deaf and Blind OR
  • His/her break in service is ≥ 4 weeks AND is > the period of employment
updated 10/22/2014

Important Documents

Tools
AskERIC Graphic
For questions about ACA please AskHR electronically, or call ERIC at 801-538-3742.

 

 

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