The General Assembly has enacted legislation that states if a rehired retiree becomes eligible under the Affordable Care Act for the ACA High Deductible Health Plan, then they must terminate their retiree health coverage. HR Benefits recommends that rehired retirees work no more than 29 hours/week.
New Employee – An employee who has not previously worked for the University/Institution or an employee who has had a break in service as defined in the key terms.
Ongoing Employee – An employee who generally has been employed for at least one complete standard measurement period.
ACA Full-Time Employee – An employee who is reasonably expected to work at least 30 hours of service per week on average and is not a seasonal employee as defined in the key terms.
ACA Non-Full-Time Employees – An employee who is NOT reasonably expected to work at least 30 hours of service per week on average. New employees will be measured during the initial measurement period and ongoing employees will be measured during the standard measurement period to determine full-time eligibility.
Initial Measurement Period – The measuring period for new employees who are not initially expected to work more than 30 hours per week. This timeframe is used to determine ACA full-time eligibility for ACA health insurance. The initial measurement period will be 3 months starting from the first of the month following the employee’s hire date.Example: The employee is hired June 10, 2023, and not reasonably expected to work 30 hours per week. The initial measurement period is July 1, 2023 – June 1, 2024.
Standard Measurement Period – The measuring period for each calendar year used to determine full-time eligibility. This period is from October 1 of the previous year to September 30 of the current year.
Administrative Period – The period of time during which the employer calculates employees’ eligibility, offers coverage, and enrolls ACA full-time employees in an ACA health plan.
– For the Initial Measurement Period, the administrative period is the month following the end of the initial measurement period.
– For the Standard Measurement Period, the administrative period is October.
If you hire people at NC State, consider the following for Affordable Care Act (ACA) compliance:
– It is important to associate the correct FTE (full-time equivalency) to job data and length of appointment in the HR System. Non-EHRA/SHRA classified employees will receive a High Deductible Health Plan offer if their standard hours are set at 30 or more hours (.75 FTE or more). Offers will also be sent to employees with standard hours set to 29 hours or less (.75 FTE or lower) if their actual hours worked reach 30 hours over any 3 month period. The UHR Benefits Office will be responsible for monitoring employees’ eligibility.
Retirees Reminder – It is important to ensure that state retirees hired into temporary positions have standard working hours set to 29 hours or below (< 0.75 FTE). The General Assembly has enacted legislation that states if a rehired retiree becomes eligible under the Affordable Care Act for the ACA High Deductible Health Plan, then they must terminate their retiree health coverage.
ACA Work Hour Exception Form (Student Workers) – An ACA Work Hour Exception no longer needs to be completed.
Cost:
$184.36 2024 Employer Cost (direct cost to department)
Click here for hiring examples.
For additional questions, reach out to UHR through HR Now, or call 919-515-2151
As a large employer, the Affordable Care Act requires us to prepare a Form 1095-C for all individuals enrolled in our employer-sponsored self-insured medical plan. For the 2020 reporting year and subsequent years, distribution requirements have changed, and we are no longer required to mail the form to any individual who is not a full-time employee for any month of the calendar year. However, if you were enrolled in our self-insured medical plan during the 2023 calendar year, you may request that a form be sent to you by contacting one of the following: hrsbenefits@ncsu.edu.
Benefits, Employee Wellness and Work Life
Human Resources
Campus Box 7210
2711 Sullivan Drive
Raleigh, NC 27695
For questions you can call: 919-515-2151
High Deductible Health Plan (HDHP)
HDHP Eligibility
The Affordable Care Act (ACA law) requires that anyone who fits the following 3 criteria must be offered the chance to enroll in the ACA health plan within their first 30 days of employment.
- Hired or rehired after January 1, 2015
- Are listed in the HR System
- Has their standard hours set as 30 or more in the HR system; OR, those that begin to average over 30 hours per week over a 3 month period
Offers are sent as close to the 1st and 15th of the month after your hire date as possible. If you believe you are eligible and should have received an offer, please submit an HR Now case.
HDHP Plan Info HDHP Cost HDHP How to Enroll Declining HDHP Coverage Retirement Options Temp Emplopyee PerksStandard Periods and Look Back Periods
Our standard measurement period will be October 1-September 30 and is conducted on an annual basis.
- We will use a 3 month look back period to determine if the temp/employee averaged 30 or more hours per week over the prior 3 month period (measurement period). If the person averaged 30 or more hours per week, health coverage must be offered within 60 days (adjustment period).
- If eligible and the person accepts the health coverage, it must last for at least 3 months regardless of hours worked. After these 3 months of coverage, if the person’s work hours average less than 30 hours per week, the coverage may be canceled. If the person terminates employment, the coverage will end.
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 offer 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: | The 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. |
Costs
The monthly cost for the ACA Health Plan for temporary employees for 2024 is:
$96.00 Temporary Employee Cost billed directly (to the employee’s home via USPS) by the plan on a monthly basis. For dependent costs paid by the employee, along with all plan rates and plan information, click here and scroll down.
How to Enroll
Temporary employees will not be able to enroll until they accept their HDHP offer. Before that occurs, employees will receive an error when attempting to log into the enrollment platform.
Once you have received your offer of HDHP coverage, you will need to communicate your intent to accept or decline the offer via HR Now. If you received your offer in an HR Now case, you can respond with your intent to enroll in the same case instead of opening a new one. Your benefits profile will be created and you will receive a notification, then you will be able to log into the benefits enrollment platform.
You will complete enrollment in the State Health Plan’s BenefitFocus enrollment platform. To navigate to the portal, log into my MyPack Portal, go to your Employee Self Service Menu, click “Benefits Details” and then click “My State Employee Benefits.”
You have 30 days from your receipt of the HDHP offer to enroll in coverage. After the 30 day period you will have to experience a Qualifying Life Event to change benefits for the current year, or wait until open enrollment in October to select benefits for the following year.
Declining Coverage and MarketPlace Options
In order to decline coverage, submit an HR Now case stating your intent to decline coverage.
The MarketPlace provides another way for employees to purchase health insurance for one’s self or dependents. The MarketPlace plans provide many types of plan at all different price points.
Subsidies are available to employees who are not offered health insurance through their employers. For more information visit www.healthcare.gov
Retirement Options
Any employee of the University whose pay is subject to FICA taxes (Medicare/Social Security) may contribute to a 403(b) or 457(b) plan.
For more information about the plan and the process of enrolling (if you are interested and have reached your hire date) please see the Voluntary/Supplemental Retirement Plan Benefits page.
An HR Now case may be submitted along with your enrollment or change form to get started or make changes to an existing plan
Related Temporary Employee Resources
Qualifying Life Events Website
2024 Summary of Preventive Care Services
2022 HDHP Formulary (Drug List)