Insurance Eligibility

Health Insurance Eligibility Policy   Purpose: The purpose of this policy is to address employees’ eligibility for health insurance and to ensure compliance with the Affordable Care Act.   Scope: This policy applies to all employees of Alamance Community College.   Health Insurance Eligibility: This list defines which employees are eligible for employer-sponsored health insurance and when they are eligible.          Employment Category/ Appointment Type  Eligibility Trigger  Eligibility Point  A  Full Time Permanent Curriculum Faculty  Hire  Time of Hire  B  Part Time Permanent Curriculum Faculty  Hire  Eligible at hire but must pay full cost of coverage  C  Full Time Temporary Faculty  Employed more than 3 months and averages 130 hours or more per month  Within 3 months of hire  D  Adjunct (Part-Time Temporary ) Curriculum Faculty  Averages less than 130 hours per month during Measurement period  Subsequent Stability Period assuming continued employment  E  Full Time Permanent Instructor  Hire  Time of Hire  F  Part Time Permanent Instructor  Hire  Eligible at hire but must pay full cost of coverage  G  Full Time Temporary Instructor  Employed more than 3 months and averages 130 hours per month during the Measurement period  Within 3 months of hire  H  Part Time Temporary Instructor  Averages more than 130 hours per month during Measurement period  Subsequent Stability Period assuming continued employment  I  Full Time Permanent Staff  Hire  Time of Hire  J  Part Time Permanent Staff  Hire  Eligible at hire but must pay full cost of coverage  K  Full Time Temporary Staff  Employed more than 3 months and averages 130 hours or more per month  Within 3 months of hire  L  Part Time Temporary Staff  Averages more than 130 hours per month  Subsequent Stability Period assuming continued employment  M  Temporary Agency Staff  May be eligible for coverage through the temporary agency  N  Independent Contractor  No coverage eligibility   Initial Determination: Supervisors, Department Heads, Deans and appropriate Vice Presidents must determine the appropriate appointment type prior to contract initiation by defining contact hours and appointment types (see above and below) Reporting: Each department is responsible for reporting the number of hours worked by each employee designated as TEMPORARY to the Payroll department by the 7th of each subsequent month. Example: Hours worked in July must be reported to Payroll by August 7. It is the individual supervisor’s responsibility to ensure that all hours are reported correctly. Payroll and/or Human Resources will generate a monthly report for review by the appropriate Vice President and Human Resources to ensure compliance with this policy and to determine who is working enough hours to be eligible for health insurance benefits. Human Resources will contact eligible employees within 30 days of eligibility to ensure enrollment or “OPT OUT” documentation is completed.  Definitions:   A. Service hours: Each hour for which an employee is credited for the performance of services and, if applicable, hours for which an employee is entitled to payment during which no duties are performed due to paid leave, such as vacation, holiday, disability, jury duty, military leave or leave of absence. For faculty/instructor positions, service hours include not only classroom instruction time, but also time spent on advising students, class preparation work, course development, office hours, committee work, and other duties as assigned or required by the College.  B. Standard/Initial Measurement period: The period of time for which an employee’s hours are recorded and measured to determine average hours worked. ACC’s Initial Measurement Period for existing employees is 12 months (November 1, 2013, through October 31, 2014). The Standard Measurement period for new employees is 12 months. For new employees, the initial measurement period begins at the date of hire.  C. Administrative period: The time after the Standard/Initial Measurement Period that it takes to enroll an eligible employee in the health plan. ACC’s First Administrative period: November 1, 2014, through December 31, 2014. For new employees, ACC’s administrative period begins within 90 days of the end of the Standard Measurement period. For existing employees, ACC’s administrative period begins within 90 days of the end of the Initial Measurement Period.  D. Stability period: The period of time after the Administrative Period for which health benefits are provided to eligible employees. ACC’s First Stability period: January 1, 2015, through December 31, 2015. For new employees, ACC’s stability period will be 12 months. For existing employees, ACC’s stability period will be 12 months.  E. Established Breaks in Service: A period of time for which an employee does not work (semester breaks, summer break, spring break, holiday breaks, etc.). Breaks are not considered when calculating total service hours.  F. Non-Established Breaks in Service: The College will determine if an employee is an “existing employee” or a “new employee.” If break in service is longer than the period of previous employment, the employee is treated as a new hire and a new Measurement Period begins.  G. Workload formula: Workload (loading) formula recognizes teaching, scholarship, and service contributions of all curriculum faculty members and non-credit instructors and helps ensure equity in workload assignments. In the North Carolina Community College System, the formula for workload is a local college decision. The formula may be based on any combination of the following: contact hours, credit hours, service hours, reassign time, academic level of the course or class membership hours (number of students). The college’s current workload formula for instructors is as follows:   1. Curriculum Lecture (safe harbor): 2.25 hours per contact hour (credit-bearing)  2. Basic Skills: 1.16 hours per contact hour (non-credit-bearing) 3. Curriculum Labs: 1.67 hours per contact hour (credit-bearing)  4. Curriculum Clinics: 1.16 hours per contact hour (credit-bearing)  5. Continuing Education: 1.25 hours per contact hour (non-credit-bearing)  6. Business & Industry: 1.25 hours per contact hour (non-credit-bearing)  7. Skills Lab: 1 hour per contact hour (non-credit-bearing)   H. Credit bearing courses: Curriculum courses for which credit hours are earned and can be applied to degrees, diplomas, and certificates.  I. Non-credit bearing classes: Classes that provide lifelong learning opportunities for personal enrichment and career building, such as Basic Skills (College and Career Readiness), Community Education, Business Development and Workforce Training, for which curriculum academic credit is not earned. Prep-time is typically lower than that required for credit-bearing courses.  J. Seasonal Employee: An employee who is employed on a temporary basis for a defined season, such as registration.  K. Independent Contract Employee: An individual who is contracted to perform a service for the college for which there is no employer/employee relationship; the college has the right to control or direct only the result of the work and not what will be done and how it will be done. The earnings of a person who is working as an independent contractor are subject to Self-Employment Tax.  L. Temporary agency employee: An employee assigned to work at the college through a staffing firm.   Employment Structure/Appointment Types  A. Full-Time Permanent Curriculum Faculty: An employee whose primary work is instruction in credit-bearing courses who works an average of at least 30 service hours per week or 130 service hours per month and is employed on an annual basis of 9 months or more with the reasonable expectation of recurring employment.  B. Part-Time Permanent Curriculum Faculty: An employee whose primary work is instruction in credit-bearing courses who works between 20-29 service hours per week and is employed on an annual contract of 9 months or more with the reasonable expectation of recurring employment.  C. Full-Time Temporary Curriculum Faculty: An employee whose primary work is instruction in credit-bearing courses who works an average of at least 30 service hours per week or 130 service hours per month and is employed with a course-based contract for 9 months or less with no expectation of recurring employment.  D. Adjunct (Part-Time Temporary) Curriculum Faculty: An employee whose primary work is instruction in credit-bearing courses who works less than 30 service hours and is employed with a course-based contract per academic term with no expectation of recurring employment outside of the contracted hours.  E. Full-Time Permanent Instructors: An employee whose primary work is instruction in non-credit bearing classes who works an average of at least 30 service hours per week or 130 service hours per month and is employed on an annual contract of 9 months or more with the reasonable expectation of continuing employment.  F. Part-Time Permanent Instructors: An employee whose primary work is instruction in non-credit bearing classes who works between 20-29 service hours per week and is employed on an annual contract of 9 or more months with the expectation of recurring employment.  G. Full-Time Temporary Instructors: An employee whose primary work is instruction in non-credit bearing classes who works an average of at least 30 service hours per week or 130 hours per month and is employed on a class-based contract for 9 months or less with no expectation of recurring employment.  H. Part-Time Temporary Instructors: An employee whose primary work is instruction in non-credit bearing classes who works less than 30 service hours per week or 130 service hours per month and is employed on a per class basis with no expectation of recurring employment outside of the contracted hours.  I. Full-Time Permanent Staff: An employee whose primary work is other than instruction who works at least 30 hours per week and is employed at will or on an annual contract basis with the expectation of recurring employment. J. Part-Time Permanent Staff: An employee whose primary work is other than instruction who works less than 130 hours per month and is employed at will or on an annual or semester contract with the expectation of recurring employment. K. Full-Time Temporary Staff: An employee whose primary work is other than instruction who works at least 30 hours per week or 130 hours per month for a period of time, not to exceed 12 months, with no expectation of recurring employment. L. Part-Time Temporary Staff: An employee whose primary work is other than instruction who works less than 130 hours per month for a period of time, not to exceed 12 months, with no expectation of recurring employment.  Measurement Periods:   A. Standard Measurement period for new employees is 12 months  B. Initial Measurement Period for existing employees is 12 months   Administrative Period: This period is used to enroll eligible part-time employees, identified during the measurement period, into health insurance coverage:   A. For new employees—begins within 90 days of the end of the Standard Measurement Period  B. For existing employees—begins within 90 days of the end of the Initial Measurement Period   Stability Period: During this period, employees who are identified as eligible for coverage during the measurement period maintain their eligibility status.   A. For new employees—this may be six months but not more than 12 months, and cannot be shorter than the Measurement Period and cannot be longer than the Measurement Period plus one month. For ACC employees, this time period will be 12 months.  B. For existing employees—this may be six months but not more than 12 months, and cannot be shorter than the Measurement Period and cannot be longer than the Measurement Period plus one month. For ACC employees, this time period will be 12 months.   Curriculum Faculty: Categories and subcategories of positions (lab, no-lab, etc.):  A. Criteria for full-time employment (# contact hours, credit hours, etc.): between 18 and 24 contact teaching hours or between 18 and 20 credit hours, and five office hours each week, and relevant committee work as assigned  B. Other activities required for full-time faculty positions that are used to determine service hours include prep time, recruiting, registration, grading papers and advising students. C. Ratio used to calculate service hours:  1. 	Curriculum Lecture (safe harbor): 2.25 hours per contact hour (credit-bearing) 2. 	Basic Skills: 1.16 hours per contact hour (non-credit-bearing) 3. 	Curriculum Labs: 1.67 hours per contact hour (credit-bearing) 4. 	Curriculum Clinics: 1.16 hours per contact hour (credit-bearing)  D. Methodology for determining calculation of service hours: working groups, including Administrative Council, Controller, Human Resources and Payroll Focus Group, determined methodology. E. Part-time faculty performs all duties of full-time faculty with the exception of student advising, registration and recruiting. F. Activities that are given credit on an hour for hour basis for part-time faculty are office hours and class preparation. G. Maximum # of service hours/contact hours/credit hours allowed for part-time faculty and is less than 130 per month. H. Payroll and/or Human Resources will be responsible for tracking and reporting hours. I. No part-time positions are eligible for paid leave.  Non-Curriculum Instructors: This section includes information for Basic Skills, Continuing Education and Business & Industry Instructors. Identify categories and subcategories of positions (Basic Skills, continuing Education, Business & Industry etc.) and for each define:   A. Criteria for full-time employment: a total of 40 but not less than 30 worked hours per week  B. Other activities that are required for full-time positions that are used to determine service hours (prep time, grading papers, advising students, etc.)  C. Ratio used to calculate service hours   1. 	Continuing Education: 1.25 hours per contact hour (non-credit-bearing)  2. 	Business & Industry: 1.25 hours per contact hour (non-credit-bearing)  3. 	Skills Lab: 1 hour per contact hour (non-credit-bearing)   D. Methodology for determining calculation of service hours: working groups, including Administrative Council, Controller, Human Resources and Payroll Focus Group, determined methodology.  E. Part-time faculty performs all duties of full-time faculty with the exception of student advising, registration and recruiting.  F. Activities that are given credit on an hour for hour basis for part-time faculty are office hours and class preparation.  G. Maximum # of service hours/contact hours/credit hours allowed for part-time faculty and is less than 130 per month.  H. Payroll and/or Human Resources will be responsible for tracking and reporting hours.  I. No part-time positions are eligible for paid leave.   Staff Employees: Full-time regular employees (non-faculty) are defined as staff employees who work a total of 40 but not less than 30 hours per week. These employees are in budgeted positions, which can be reasonably expected to be funded on a continuing basis and are selected and appointed based on all the requirements of the College’s Personnel Employment Procedures. Such employees are eligible for health insurance.  Changes in Employee’s Position Status: Employee position status changes will be in accordance with all applicable local, state and federal employment law, including criteria set forth in the ACA that establishes an employee’s eligibility for being offered health benefits by the College. Multiple Positions:   A. Employees who work multiple part-time positions are required to complete a Secondary Employment form and submit it to the appropriate supervisor, Vice President’s and President’s office for approval BEFORE beginning work in the second job.  B. If the employee is working in two or more different types of positions, then each position’s hours will be calculated according to the position  C. Employees in multiple positions shall not exceed 130 hours worked per month.   Opting Out procedures: Any employee may choose to not accept coverage in the health plan. Employees should annually complete a form that acknowledges that they were offered coverage and chose not to accept the coverage. Once an employee opts out for the plan year, they cannot enroll again until the next annual enrollment.  Breaks In Service (On-Going v. New Hire): The types of break in service determine if an employee is classified as "existing" or a "new hire". Different rules apply to the “look-back” method of Safe Harbor that is used to analyze these two types of employees who have had a break in service. Consider these scenarios:   Scenario 1 - An employee has a period of time which is less than 4 weeks for which they have 0 hours worked: Because the period during which the employee did not work is less than four weeks, it is not an “employment break period”. Therefore, you would treat this employee as an “on-going” employee and record only the actual hours worked. You continue with the same measurement period and stability period that they originally started with.   Scenario 2 - An employee has a period of time which is greater than 26 weeks for they have 0 hours worked and start to work with the employer again after 26 weeks: Because the period of time for which the individual did not work is greater than 26 weeks, this is not considered an "employment break period" but rather the employee is treated as a rehire/new employee and you would start over with a new measurement period.  Scenario 3 - An employee has a break of service of between 4 and 26 weeks and the break in service is greater than their period of employment: For example, an employee works for five weeks for an employer and then leaves employment. He/she comes back to work ten weeks after this. In this case, the individual is treated as a rehire/new employee because the break of ten weeks is greater than four weeks and greater than the period of employment of five weeks. You would start over with a new measurement period.   Scenario 4 - An employee has a break in service of between 4 and 26 weeks and the break in service is less than the period of employment: For example, an employee works for ten weeks, leaves employment, and returns five weeks later. This would be considered an "employment break" and the individual would be treated as an on-going employee because the break in service of five weeks was greater than four weeks and less than the period of employment of ten weeks. The measurement and stability period that would have applied to the employee had the employee not had an employment break would continue to apply upon the employee's resumption of service.   Under this scenario, employers using the “look-back” method must either:  calculate their average hours worked per week excluding the break period, or  treat the employee as having worked their average weekly hours during the “employment break” period (even though the employee did not in fact work during the break period).  References  1.	Procedure (to be established, will include method for tracking hours)  2. 	Payroll Focus Group (to be established)  3. 	Secondary Employment Approval Form  4. 	State Board Code (in process of changing)   Effective Date: July 1, 2014   Policy Owner: Human Resources   Source:	Board Action: Board Minutes, August 11, 2014