Payroll Personnel System

The Affordable Care Act (ACA)

IRS Form 1095

Starting with the 2015 tax year, a new IRS Form 1095 will be issued, as required by the Affordable Care Act (ACA). Read the details on mailing dates from UC and filiing your taxes for 2015.

Background

Provisions of the Affordable Care Act (ACA) require that UC offer medical insurance to “substantially all” employees reasonably expected to work on average, 30 hours of service per week for 3 months or more.  This change will expand coverage to employee classes previously considered ineligible, including:

  • Students employed under appointment type “casual-restricted.” (Hours paid under Federal Work Study programs are excluded from the 30 hours/week average calculation.)
  • Graduate Student employees with cumulative appointments that average 75% time or greater
  • Staff employed under “per diem” appointments
  • Academic, staff, and students employed and paid under a flat rate amount arrangement such as BYA, SST or SSC.

UC has decided to offer the CORE Benefits Package--CORE Medical, CORE Life, Legal, AD&D, Family Care Resources, and the Health/DepCare Flexible Spending Accounts, for any employee with a By Agreement appointment only and zero hours credited during each measurement period.  These employees will be automatically offered the CORE Benefits Package.  Therefore, it is important that departments credit hours for these employees.  The hours do not impact any other accumulators, such as the 1,000/750 hours toward benefits eligibility, vacation or sick leave accruals, career status, etc., nor does it affect payment.

UC will now measure the average hours of service once a year, in November, over a 12-month “look-back” period, rather than checking this measurement each month. In other words, once an employee becomes eligible for medical benefits coverage, they remain eligible for at least 12 months. “Average Weekly Hours of Service” is the measurement used to calculate ongoing benefits eligibility. Most employees will remain eligible for benefits coverage if they work an average of 17.5 hours per week during the look-back period.

For employees hired prior to January 1, 2016 and have been or are currently paid a flat rate amount, the determination of eligibility is based on a calculation of hours worked during a 12-month “look-back” measurement period which started in November 2014. Consequently, employees paid a flat rate amount may qualify for UC insurance in 2016, based on their employment history. 

Employees hired on or after January 1, 2016 and are paid a flat rate amount (e.g. BYA) will be offered the CORE Benefits Package, effective on their hire date, if they are expected to average 30 hours/week, for 3 months or more with the flat rate appointment alone or in combination with other appointments.  Others may qualify based on a “look-back” measurement period over their historical hours.

Action Needed

There are 2 different actions that will need to be completed for crediting hours to employees paid a flat rate (i.e., BYA DOS code) in PPS.

1)      Employees who were paid and continue to be paid a flat rate  (i.e., BYA DOS code) from November 1, 2014 to October 31, 2015 (MO) or November 9, 2014 to November 7, 2015 (BW) are included in  the “look-back” measurement period. Departments will credit hours using an LX transactionCrediting hours must be completed by October 31, 2015

For Academic Appointees who were paid for a flat dollar amount rate, Academic Personnel has developed a matrix (attached) to determine how to determine hours of work for those holding teaching titles, those who are Lecturers in Summer Sessions and titles with additional duties other than teaching, such as Visiting Professors.  TA’s and Associate Ins are also included on the chart.  Their formula is based on the formula outlined in Article 24 of the BX MOU.

2)      Employees paid a flat rate (i.e., BYA DOS code) after October 31, 2015 (for those paid monthly) or November 7, 2015 (for those paid bi-weekly), are included in the going forward process. Departments will use a new PPS DOS code of “BYH” to credit hours- this code does not issue any payment.  Crediting hours should be done at the time the flat rate payment is set up on a separate distribution line.

(See the link to the BYH step-by-step PPS instructions below, under, “Resources”)

Title codes and DOS code excluded

The following is a list of title codes and a DOS code that have been excluded from the new UC benefits eligibility rules and therefore no action will be required.

  • 4329 (Student Activities, Appointed Official)
  • 9920 (Student Volunteer)
  • UNX (DOS code)
Academic Appointments

No action is required for academic employees paid flat-rate payments that are additional compensation over the REG 100% (i.e. stipends, flat rate summer comp). 

Resources

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