1. Episode 1: New UC Benefits Eligibility Rules. UCSB Benefits
Episode 1: New UC Benefits Eligibility Rules UCSB Benefits December 2015

2. Agenda Employer Shared Responsibility Review (ACA)
What’s Not Changing for 2016
What is Changing for 2016
New Concepts
Initial Eligibility
Continuing Eligibility
Example Scenarios
What is Happening Now

3. Employer Shared Responsibility
Affordable Care Act of 2010
Employer Shared Responsibility
To comply with the ACA, UC is required to change benefits eligibility rules for all employee starting in January 2016.
No category of employees may be excluded
Definition of hours we count must change
New provisions will make it easier for employees to maintain UC coverage
More employees may be offered coverage
There are severe financial penalties for non-compliance

4. What’s Not Changing?

5. What’s NOT Changing? 2015 2016 1,000 hour rule/ 750 hour rule
Rolling hours toward UCRP (and BELI 1)
System will continue to automatically assign BELI 1 and derive retirement codes
Central Benefits coordination
No change
BELI/Benefit Packages
BELI 1, 2, 3, 4
Full, Mid-Level and Core
BELI 5
No benefits
BELI P – Postdoctoral Scholars
Initial Eligibility Rules
For currently eligible employees

6. What’s Changing?

7. What’s Changing? 2015 2016 Eligible Categories
Appointment Types 1, 2, 3, 5, 7, & 8
Group A :Appointment Types 1, 2, 3, 5, 7, & 8
Group B:
Appointment Types 4, 5(student academic appts) & 6
Ineligible Categories
Appointment Types 4 (Students: Casual/Restricted)
Appt. Type 5 (Academic Students)
Appt. Type 6 (Per Diems)
Employees paid flat rates- BYA, SST
None

8. What’s Changing? 2015 2016 Continuing Eligibility Measurement Method
Average regular paid time calculated monthly using a rolling 12-month period
Average weekly hours of service calculated annually using a 12-month look-back period
Continuing Eligibility: Measurement Timeframe
Rolling 12-month look-back period
Standard, 12-month look-back period
Monthly: Nov 1 – Oct 31
Biweekly: Nov 9–Nov 7
(bi-weekly dates may vary each year)
Continuing Eligibility Requirement
17.5 average regular paid time
Group A -
17.5 avg. weekly ‘hours of service’
Group B -
30 avg. weekly ‘hours of service”

9. What’s Changing?
2015
2016
Continuing Eligibility: Hours Included in the Calculation
“Average Regular Paid Time”
“Average Hours of Service”
PAID TIME
Any and All paid time, for example: regular pay, summer salary pay, paid time for vacation, paid holiday, paid illness, paid jury duty, paid military duty, or paid leave of absence, paid sabbatical, etc.,
UNPAID TIME
Unpaid Jury Duty
Unpaid Hours during “special employment breaks” of at least 4 weeks (501 hours max)

10. What’s Changing?
2015
2016
Continuing Eligibility: Hours NOT Counted in the Calculation
Unpaid time &
Summer salary hours
All other unpaid time that is not listed above.
Work study
Hours worked under title codes 4329, 9920,
Auto Enrollment in the event employee takes no action during PIE
Default Auto enrollment continues through 12/31/15
NO automatic enrollment as of PIE of 01/01/2016 or later
Applies to Groups A & B
No automatic Core or Delta Dental or VSP
Automatic enrollment into Core/Basic Life and Short-term Disability (if applicable)
The period of time an employee can remain enrolled
Month-to-month
Stability Period = Year-to-year

12. New Concepts Group A and Group B Benefit Coverage Periods
Beginning Benefits Eligibility Period
Initial Stability Period
Stability Period
Measurement Periods
Initial Measurement Period
Standard Measurement Period
BYH DOS code

13. Group A: Appointment Types 1, 2, 3, *5, 7, & 8

14. Group A: Appointment Types 1, 2, 3, *5, 7, & 8 Eligibility Requirements
(*5 – May be in Group A or B based on title code, see Group B chart)
ASSIGNED BENEFIT PACKAGE AND BELI CODE
Combined Appointment % & Duration
UCRP
Membership Required?
Continuing Requirements
 Examples
Full Benefits, BELI 1
50% or more for 12 months or more 
Accumulation of 1,000-eligible hrs (or 750 hrs for Unit 18) in a rolling 12-month period.
YES
Minimum 17.5 average hours of service weekly, measured after each standard measurement period
Admin Assistant I, appointed indefinitely at 50% time
Lecturer, 7/1/16 to 6/30/17 at 66% time
Mid-Level Benefits, BELI 2
50% or more for 12 months or more (but not eligible for UCRP) NO
”Visiting” Professor, 7/1/16 to 6/30/17 at 50% time
Mid-Level Benefits, BELI 3
100% for 3 months or more, but less than one year
CRS II appointed at 100% from 9/1/16 to 12/1/16 (3 months)
Lecturer, 10/1/16 to 12/31/16 (1 quarter) at 100%
Assistant I, 1/1/16 to 12/15/16 (11.5 months) at 100%
Core Benefits, BELI 4
43.75% or more but does not satisfy % and duration for BELI 1, 2, or 3
Senior Clerk, one month, 100%
Employee appointed at % indefinitely
Lab Assistant 9/15/16—11/30/16 at 100% (less than 3 months)

15. Group B: Appointment Type 4: Casual/Restricted (students)
Appointment Type 5: Student Academics
Appointment Type 6: Per Diem appointments
Salary Rate Indicator is “By Agreement” with pay related to work (flat rate pay)

16. Combined Appointment % & Duration Continuing Requirement
Group B: Appointment Types 4, *5 6, BYA Eligibility Requirements
Appointment Type 4: Casual/Restricted position (students only) or Academic title code (Class Title Outline – CTO of ) which is restricted to students, but may be filled by non-students based on need
Appointment Type 5*: Any Academic Student Title including ASE and GSR Titles
Appointment Type 6: Per Diem appointments
Salary Rate Indicator is “By Agreement” with pay related to work, flat rate pay
ASSIGNED BELI CODE
Combined Appointment % & Duration
UCRP
Membership Required?
Continuing Requirement
 Examples
Core Benefits, BELI 4.
75% or more for 3 months or more NO
Minimum 30 average hours of service weekly measured after each standard measurement period
Student with two appointments, totaling 75% or more indefinitely
Assistant I, 15 hours/week, indefinitely (student title) PLUS
Assistant I, 15 hours/week) indefinitely (student title) = 75% time indefinitely
Nurse, Per Diem, 90% indefinitely
No Benefits. BELI 5
Don’t meet % and duration above
Subject to initial and standard measurement periods, with a threshold of 30 average hours of service weekly
Recreation Instructor, 3 hours per week

17. Benefit Coverage Periods
Beginning Benefits Eligibility Period (BBE)
The period of time a newly eligible employee maintains eligibility until they can complete a full Standard Measurement Period
It can last longer than 12 months
Must be assigned a BELI 1-4 when initially hired or newly eligible
Initial Stability Period (ISP) No longer using this concept
First 12 months of coverage after completing an Initial Measurement Period
Stability Period (SP)
The period of time an employee is eligible to maintain coverage
January 1 to December 31 of each year
Follows a Beginning Benefits Eligibility Period

18. Measurement Periods Initial Measurement Period
Applies to employees not initially eligible for benefits (BELI 5)
Measures hours of service to determine benefits eligibility
12 month period starting with date of hire
After 12 months, if average weekly hours are at or above the threshold for benefits eligibility, a PIE for benefits is offered.
If not eligible, no action needed.
If eligible, system auto-assigns the BELI 4 the first of the following month.

19. Measurement Periods Standard Measurement Period
Applies to all employees
Measures hours of service to determine benefits eligibility for next calendar year
Measurement is done during the same timeframe each year using a 12 month lookback period
November 1 - October 31 (monthly paid)
Nov 9 – Nov 7 (bi-weekly paid; dates will change slightly each year for bi-weekly employees)

20. Measurement Periods Standard Measurement Period cont’d
If average weekly hours are AT/ABOVE the threshold for benefits eligibility:
If not already eligible – BELI is changed to 4 and a PIE for benefits is offered for an effective date of Jan 1st of the next year
If already eligible – benefits continue
If average weekly hours are BELOW the threshold for benefits eligibility:
If not already eligible – continue to be not eligible
If already eligible – loss of ongoing eligibility – change to BELI 5 effective Jan 1

22. Group A & B: Initially Eligible & Continuing Eligibility
If eligibility is awarded on DOH, it will continue until January 1 of the year following the first complete standard measurement period in which average hours of service per week is less than 17.5/30 hours; then subject to Standard Measurement
Nov 2014
Dec 2014
Jan 2015
Feb 2015
March 2015
April 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
Mar 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
DOH 4/1/2015 BELI 1-4
Beginning Benefits Eligibility
2017 Stability Period
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
Measure here. Meet threshold, benefits continue for If not, benefits end 12/31/2016
Measure here. Meet threshold benefits continue for If not, benefits end 12/31/2017
Not able to measure until employed for entire standard measurement period

23. GROUP A and B : Not Eligible on Date of Hire revised
Initially IN-ELIGIBLE, BELI 5 on DOH. Start the Initial measurement period beginning on DOH
A change in status during initial measurement period (increase in hours worked, etc.) such that the employee now qualifies.
Start the Initial Stability Period effective the new BELI date.
Employee is still measured at the end of the SMP and if no longer eligible, benefits end at the end of the ISP.
Nov 2014
Dec 2014
Jan 2015
Feb 2015
March 2015
April 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
Mar 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
DOH 4/1/2015, BELI 5
Initial Measurement Period
BBE
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
Measured eligible
BBE based on BELI effective date
Not measured must complete a SMP
Not measured

24. Example: Group A-Employee Reaches 1,000 Hours
July 1, 2015: Appointed to Limited position, 75% for 11 months. Assign BELI 4 effective July 1,
February 2016: Reaches 1,000 hours so appointment changed to BELI 1effective March 1, 2016; New BBE Stability
Nov/Dec 2016: Measured for 2017 eligibility; avg. hours are above 17.5; Benefits continue for entire 2017 Benefits Stability Period (as long as employed)
Nov 2014
Dec 2014
Jan 2015
Feb 2015
March 2015
April 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
Mar 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
DOH 7/1/2015, BELI 4
BELI 4Beginning Benefits Eligibility
Reaches 1,000 hours in February 2016; CHANGE TO BELI 1, effective 3/1/2016
BELI 1 BBE
Not measured-must complete SMP as BELI 1
Measure here
Note: 1,000/750 hour rule still applies

25. Example: Lecturer hired for the academic year with varying percentages for each quarter.
7/1/2014: Average equals 66% so assigned a BELI 2 until they complete a full standard measurement period.
3/15/2015: Reaches 750 hrs and becomes a BELI 1 on 4/1/2015.
7/1/2015: Lecturer continues to be reappointed with the same percentages
11/2015: Standard Measurement Period. Lecturer meets the 17.5 hrs over the last 12 months so BELI 1 status remains until the next measurement period
July 1, 2014
Aug 2014
Sept 2014
Oct 2014
Nov 2014
Dec 2014
Jan 2015
Feb 2015
Mar 2015
Apr 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
Mar 2016
Apr 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Beginning Benefits Eligibility
Spring Q 100%
BELI 1 BBE
DOH 7/1/2014, 67% Fall
Reappointed with percentages 33/33/33
Measure here to determine benefits eligibility for 2017
Not measured-must complete a SMP as BELI 1
Accrues 750 hours; change to BELI 1
Winter Q 33%
SMP
Standard Measurement Period
Standard Measurement Period

26. Quiz - Initial and Continuing Eligibility
DOH is Feb 1, 2016 and assigned a BELI 4.
Beginning Benefits Eligibility (BBE) =
Applicable Standard Measurement Period =
Employee’s hours are reduced to 10 hours a week on August 1, 2016, do you change the BELI?
Do benefits end?
Do benefits continue if the employee changes departments?
Nov 2014
Dec 2014
Jan 2015
Feb 2015
March 2015
April 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
Mar 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period

27. What You Need to Know Now

28. It’s happening now….. The first measurement period was from
November 1, to October 31, 2015 for monthly paid employees and
November 9, 2014 to November 7, 2015 for bi-weekly paid employees.
This measurement period includes everyone who is in PPS:
Must have been hired on/before 11/1/2014 (or 11/9/2014) AND
Must have received pay within the measurement period
Those currently on leave, sabbatical, separated, inactive, etc. are all included as long as they meet criteria

29. GROUP A & B: Happening now …. BELI 5 employees and measured eligible…
GROUP A & B: Happening now …. BELI 5 employees and measured eligible… / 30 average hrs
If eligibility is awarded on Jan 1, 2016:
Offer letter will be mailed to the employee this month by third party vendor.
PPS will auto assign a BELI 4, effective in the, assigned field.
PIE to AYSO will be available for enrollment as of
Eligibility will continue until Dec 31, 2016 unless employee is separated.
Nov 2014
Dec 2014
Jan 2015
Feb 2015
March 2015
April 2015
May 2015
June 2015
July 2015
Aug 2015
Sept 2015
Oct 2015
Nov 2015
Dec 2015
Jan 2016
Feb 2016
March 2016
April 2016
May 2016
June 2016
July 2016
Aug 2016
Sept 2016
Oct 2016
Nov 2016
Dec 2016
Jan 2017
Feb 2017
Mar 2017
April 2017
May 2017
June 2017
July 2017
Aug 2017
Sept 2017
Oct 2017
Nov 2017
Dec 2017
Hired on or before & BELI 5
Stability Period
Stability Period
Standard Measurement Period
Standard Measurement Period
Standard Measurement Period
Measure here. If 17.5/30.0 hours or above, offer CORE benefits for 2016.
Measure here. If 17.5 /30.0 hours or above, benefits continue for 2017 stability period. If not, benefits end 12/31/2016

30. Happening now…….. Group A – If no longer eligible based on SMP
UCOP sends a report to the Campus/Benefits office with employees who appear to not meet the eligibility requirements
Benefits Office will do the following:
Determine loss of eligibility.
Loss of eligibility notice/letter sent to the employee.
Manually update BELI to 5, effective
Benefits end
Send COBRA qualifying event to CONEXIS

31. BYH Information
BYH DOS code has been added to PPS in order to attribute hours of service for “flat dollar-paid” employees.
Examples of DOS codes used to pay flat dollar-paid employees are BYA and SST.
Purpose of BYH is to determine which employees are full time under ACA regulations
BYH DOS code does NOT generate pay; BYH DOES credit hours of service
BYH does not impact any other accumulations, such as the 1,000 hours toward benefits eligibility, vacation or sick leave accruals, career status, etc.

32. BYH Information, cont’d
UC has made the decision that any employee with a By Agreement appointment only and zero hours during the measurement period will be automatically offered the CORE Benefits Package
BYH instructions can be found on the following link, under PPS Tools and Resources.
0.4000

33. Recap Some employees will gain eligibility, eff 1-1-16 Automated
Some employees will lose eligibility, eff
Manual-Local Benefits office
Departments continue to assign BELI upon hired date and when eligibility increases due to changes in appointments.
LISA

34. Questions? EPISODE 2: Brief overview of Episode 1 Employment Breaks
Job Changes,
Re-hires
More Concepts and terms
Advanced Scenarios
LISA