Question
What are some common questions related to the Affordable Care Act (ACA)?
Answer
Eligibility and Coverage
- How is ACA eligibility determined?
- Employees who are not otherwise benefits-eligible—including temporary employees, adjunct or part-time faculty, graduate assistants, and student employees (excluding work-study positions)—must be monitored for ACA purposes.
- These employees may become ACA-eligible if they meet either of the following criteria:They work an average of 30 hours per week (1,560 hours total) during a 12-month measurement period; or
- They were previously benefits-eligible at an SDBOR institution and are rehired in any capacity within 26 weeks of separation.
Note: Federal and state work-study positions are excluded from ACA tracking and eligibility requirements.
- What is the difference between a benefits-eligible employee and an ACA-eligible employee?
- Benefits-eligible employees are in permanent or regular positions and receive the full benefits package (health insurance, retirement contributions, leave, dental/vision insurance, etc.).
- ACA-eligible employees are in non-benefits-eligible positions but meet ACA criteria. They are offered health insurance only and are not eligible for retirement contributions or leave.
- When does ACA coverage begin once an employee becomes eligible?
- Coverage begins on the first day of the month following the determination.
Example: If an employee qualifies for ACA coverage after the September pay period, their insurance starts October 1.
- What happens if an ACA-eligible employee declines health insurance?
- The department still owes the employer cost of benefits for ACA purposes while the employee is active, even if the employee declines coverage.
- If we rehire a benefit-eligible employee into a temporary position, how long must their break in service be before they are no longer eligible for ACA benefits?
- They remain ACA-eligible unless they have a break in service of 26 weeks or longer before rehire.
- What is meant by the “30-hour threshold”?
- Under the Affordable Care Act, an employee is considered “full-time” if they work an average of 30 hours per week (or 1,560 hours total) during a 12-month measurement period. Reaching or exceeding this 30-hour average triggers eligibility for ACA health insurance benefits, even if the employee is in a temporary or non-benefits-eligible position. This standard is based on actual hours worked, and differs from the Fair Labor Standards Act (FLSA) definition of full-time, which is used for overtime purposes.
- Are work-study hours included when determining ACA eligibility?
- No. Federal or state work-study hours are excluded from ACA hour calculations. However, any non–work-study hours a student works are counted.
- What happens if an employee holds multiple part-time positions across campus or within the SDBOR system?
- All active SDBOR appointments are combined when determining ACA eligibility. This means that hours worked in multiple positions may collectively exceed the 30-hour threshold. To ensure compliance, departments should:
- Verify whether candidates currently hold or recently held other positions within USD or any SDBOR institution before making a hiring decision (see Hiring Considerations section).
- Coordinate with other hiring departments to manage total hours across appointments.
- Consult with Human Resources to confirm current positions, ACA eligibility status, and prevent an employee from inadvertently becoming ACA-eligible.
Timekeeping and Hour Tracking
- Who is responsible for monitoring hours for ACA purposes?
- Departments are responsible for ensuring employees do not exceed the 30-hour threshold (considering all active SDBOR appointments)
- Human Resources assists with tracking and will notify departments when employees are nearing eligibility.
- How are hours tracked for Graduate Research Assistants (GRAs) and Graduate Clinical Assistants (GCAs)?
- GRAs and GCAs record compensable hours in an ACA Work Log. These hours are used only to track ACA eligibility and do not affect pay.
- How are hours calculated for salaried Adjuncts and Graduate Teaching Assistants (GTAs)?
- SDBOR follows the IRS-approved formula:
- Credit hours × 2.25 + service hours = total weekly hours
- Adjunct/PT Faculty should average under 30 hours/week
- GTA–Instructor of Record should average under 20 hours/week
- Please review the ACA Credit Hour Formula One Stop Article for more information.
- How are hours calculated for Graduate Administrative Assistants (GAAs)?
- GAAs are paid hourly and submit timesheets each pay cycle. The hours on their timesheet are used to calculate their ACA average.
- Are Graduate Administrative Assistants eligible for overtime pay?
- Yes. GAAs are FLSA non-exempt and earn time and a half for hours worked over 40 per week, consistent with SDBOR overtime policies.
- Do hours worked at another state entity or outside company (e.g., Sodexo) count toward ACA eligibility?
- No. Only hours worked at an SDBOR institution are included.
Hiring and Budget Considerations
- Can a hiring manager ask about ACA status or work history within SDBOR?
- Yes. For budgetary purposes, hiring managers may ask approved ACA-related questions during interviews.
- Please refer to the ACA Questions for Hiring Managers Article for specific examples of acceptable questions.
- Can a department decline to hire a candidate because they are ACA-eligible?
- Budgetary reasons can be an acceptable reason to decline hiring a candidate. If you are unsure if a candidate will be or may become ACA eligible, please reach out to the Human Resources office to verify their ACA eligibility before declining to hire the candidate.
- What should a hiring manager do if they’re unsure about a candidate’s ACA status?
- Contact Human Resources before finalizing the hire to verify whether the candidate is or may become ACA-eligible based on prior SDBOR employment.