Why Your Eligibility for Employer Health Coverage Can Change Presented by Touchstone Consulting Group © 2014 Zywave, Inc. All rights reserved.

Background Affordable Care Act (ACA) requirements –Applicable large employers must offer health insurance to full-time employees and their dependents Must be “affordable” Must provide “minimum value” – is an applicable large employer, and we offer health coverage to our full-time employees Variable-hour employees may flex between full- and part-time status, meaning your eligibility for health coverage may change

What counts as full-time employment? For periods of time where you are considered a full-time employee, you are eligible for health insurance Full-time employment is defined as one of the following: –Average of at least 30 hours of service per week, OR –130 hours in a calendar month

What are hours of service? Hours of service are those that count toward your full-time designation. They include the following: –Hours worked –Hours for which you were entitled to pay, such as: Vacation Leave of absence Jury duty Disability

How are hours calculated? There are two methods: –Monthly measurement period –Look-back measurement period Certain specified categories of employees must have their employment status determined with the same method.

Monthly Measurement Method Your hours are tallied each calendar month to determine whether you were full-time With a variable-hour schedule, you could switch between full- and part-time status each month –May be offered coverage on a month-to-month basis to match each month’s eligibility status

Look-back Measurement Method Three parts: –Standard measurement period (SMP) Three to 12 months Determines full-time status –Stability period As long as or longer than SMP Full-time status or not based on prior SMP –Administration period Time during which eligibility determinations and coverage offers to eligible employees are made An initial measurement period applies for new employees and typically overlaps with the first SMP

How this affects you will monitor the hours you work each month, calculate your status according to the appropriate method and inform you of your status regarding insurance coverage.

Summary Health coverage eligibility depends on full-time employment status Full-time status determined in one of two ways: –Monthly measurement method Eligibility can change from month to month –Look-back measurement method Eligibility can only change with a new stability period Other factors besides full-time status may affect your eligibility for employer-sponsored health coverage