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Affordable Care Act

...(Healthcare Reform)



President Obama signed the Patient Protection and Affordable Care Act (ACA) into law in March 2010. This comprehensive health-care reform law is intended to expand Americans' access to affordable health-care insurance.  

The University is required to offer medical insurance coverage that provides minimum essential coverage to its full-time employees or be subject to a large employer tax each year. Current University employees who are half-time or greater in a benefits eligible appointment, will not see any change.


What You Should Know


The University’s benefit plans meet the ACA's requirements for affordable employee coverage and benefit value, and fulfill the requirement that individuals have health insurance coverage.


  What the Law Requires You to Do

The ACA requires most Americans to have medical insurance by January 1, 2014. The law offers you flexibility to choose how and where to get coverage. If an individual already has health insurance through an employer-sponsored plan like the University plan, Medicaid, Medicare, or private insurance, you can remain enrolled in it. Another option is for you to purchase health insurance from the Health Insurance Marketplace.

Benefits eligible employees have access to health plans that more than meet the minimum federal requirements for health plan coverage. The University also substantially subsidizes the premium for the health plans, with the Green plan; employee only coverage having a no-cost premium ($0). As a result we don't expect benefits eligible employees will desire to purchase a health plan through the Marketplace.

The Marketplace is a central web portal that individuals without employer-based health insurance can purchase insurance. Unless an individual or family has income in the federal poverty range outlined on the Exchange, participants cannot expect a government subsidy of the cost. The University cannot subsidize the premium of the Marketplace plan either. 

Those less than half-time employees who are NOT benefits eligible may find the Exchange a greatly improved way to access health insurance plans.


What the University Does to Comply


Effective January 1, 2015, large employers (50 or more employees) will incur penalties if health insurance benefits are not offered to employees who average 30 or more work hours per week.

University employees who are half-time or greater are already offered health insurance benefits. This is good news for the University, as the ACA requirements are met.

For employees who work on average less than 30 hours per week, the University is required to use a Lookback Period, an Administrative Period and a Stability Period. The appointment percentage of time will be calculated by crediting the classes taught in a semester or by applying a reasonable, defensible and consistent computation for employees in the department. One mechanism to determine percent of time for employees in a classroom is to review the credit hours assigned for a particular academic semester or academic year. For positions that are administrative or research related, the department must determine a reasonable percent of time that is consistently applied. 

If an employee worked on average 30 or more hours per week during the 12 months lookback period, the University will make an offer of medical coverage to the employee during the 12 month stability period. The employee may receive medical coverage for the entire 12 month stability period regardless of the number of hours worked in this timeframe.

Human Resources will identify and notify those employees deemed to receive an offer of coverage due to meeting the 30 or more hour threshold a week. The employee must average 30 hours per week for the entire 12-month period. If an employee doesn’t respond to the enrollment requirement within the stated timeframe, employees will be defaulted into the Green medical plan, post-tax, employee only coverage.

Student employees need to know they are not exempt from this law and if an offer of coverage is received due to meeting the 30 or more hour threshold a week over a 12 month lookback period, you must return the enrollment forms for medical coverage or be defaulted into coverage automatically. Even if the student has insurance coverage through the University student plan or another plan, we are required to offer our employer health plan coverage to employees working 30 or more hours a week. 

To comply with the ACA and ensure that all employees who average 30 or more work hours per week are offered health insurance benefits, the University is required to monitor the employment and hours worked by employees who are not benefits eligible.


Variable Hour Student, Non-Student Hourly, and Graduate Students


In compliance with health care reform regulations (ACA), beginning January 1, 2015, Human Resources has performed a variable-hour employee calculation to determine whether an employee (student, non-student hourly, graduate student) has met the 30-hour weekly average over the course of a 12-month measurement period to gain eligibility for the University’s self-funded employee medical plans. The calculation is complex with many varied intricacies, which may create inquiries from variable hour employee workers to better understand how this is accomplished. 

Employees (variable hour students, non-student hourly and graduate students) at CSU have the ability to obtain medical coverage through different sources, including maintaining coverage up to age 26 on a parent’s employer sponsored plan; purchasing individual coverage; maintaining enrollment in the Student Health Plan administered by CSU Health Network (premiums are not refundable and cannot be prorated and the graduate student health contribution cannot be applied towards the University’s employee medical plan) or purchasing a policy through the ACA Marketplace Exchange (eligibility criteria is specific to each referenced plan). 

If you wish to keep your current insurance plan, you may decline coverage on the enrollment form and return it to Human Resources. You must either elect medical coverage or decline coverage no later than the specified due date.