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This is especially true if you are an employer in an industry that relies on employing large numbers of variable hour employees, such as restaurants, staffing organizations, and home health care facilities.
Under the ACA’s Employer Mandate, employers with 50 or more full-time employees and full-time equivalent employees are required to offer Minimum Essential Coverage (MEC) to at least 95% of their full-time workforce (and their dependents) whereby such coverage meets Minimum Value (MV) and is Affordable for the employee or be subject to IRS 4980H penalties. The IRS calls these organizations
If you are an ALE with a predominately variable-hour workforce, you’ve likely been directed to use the IRS’s Look-Back Measurement Method to determine which of your employees are considered full-time. Under the Look-Back Measurement Method, employers are allowed to monitor and track their employees’ hours of service for as little as three months and as long as 12 months to determine if they are full-time or part-time before extending an offer of health coverage. Under the ACA, the IRS defines a full-time employee for any calendar month as “an employee employed on average at least 30 hours of service per week, or 130 hours of service per month.”
The Rule of Parity, as cited from the IRS regulations, is as follows: “For purposes of determining the period after which an employee may be treated as having terminated employment and having been rehired, an applicable large employer may choose a period, measured in weeks, of at least four consecutive weeks during which the employee was not credited with any hours of service that exceeds the number of weeks of that employee’s period of employment with the applicable large employer immediately preceding the period that is shorter than 13 weeks (for an employee of an educational organization employer, a period that is shorter than 26 weeks).”
Here’s an example:
John Doe works as a dishwasher with a variable-hour schedule at a local restaurant. He has been employed by the restaurant for three years. He was determined to be full-time during his measurement period under the Look-Back Measurement Method and was receiving health benefits from his employer during his corresponding stability period. He left the restaurant to pursue a job as a house painter during that stability period. He returned to the restaurant after 16weeks. When John returned, his employer no longer treated him as a full-time employee. Instead, the restaurant treated him as a new hire and started measuring his initial measurement period under the ACA as allowed by the Rule of Parity.
If John had returned to the restaurant before 13 weeks, rather than waiting to return until after 13 weeks (and in his case 16 weeks), his employer would have had to extend him an offer of health coverage for the remainder of his prior stability period because John was counted as a full-time employee as measured during his prior measurement period. But, because John had left his employment at the restaurant for more than 13 weeks, the restaurant could consider him a new hire under the ACA regulations, despite his three years of previous service.
In this case, the Rule of Parity relieves the restaurant from having to continue to pay John’s health insurance as a full-time employee by taking into account the length of time John was not working at the restaurant.
Consider outsourcing a third-party expert who specializes in ACA compliance, data consolidation, and analytics to avoid the headache and focus your resources on bettering your business.
ACA is complex, stop trying to place a square peg into a round opening and start thinking outside the current benefit box as one plan does not fit all needs. Thanks to our partners at the ACA Times for their continued ACA regulation updates.
©2020 Innovative Health Insurance Advisors
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