00:00:01.060 - 00:00:08.770
Amber Posthauer: Hello, everyone. Thank you for joining us today. We're going to get started in 60 seconds to allow everyone to get connected. We'll get started shortly.
00:00:39.240 - 00:00:47.379
Amber Posthauer: Welcome, everyone, to How Do You Measure Up? a refresher on ACA employer mandate measurement methods. Thank you all so much for joining us.
00:00:47.560 - 00:00:58.639
Amber Posthauer: The Benefits Compliance Team will be answering the questions you send through the Q&A today. We'll try our best to answer all of your questions, but if for whatever reason we're unable to get to your question today, please follow up with your advisor for further assistance.
00:00:58.980 - 00:01:09.099
Amber Posthauer: Today's presentation is being recorded. We'll be sharing the recording in the follow-up email and on the NFP website. If there are any portions of this call that you missed, by Monday you'll receive an email with a link to the full recording.
00:01:09.220 - 00:01:12.750
Amber Posthauer: The PowerPoint slides used during this presentation will be shared in the same email.
00:01:13.120 - 00:01:24.559
Amber Posthauer: At this time, I'll hand it over to Kelly Ackman, Vice President of NFP Benefits Compliance, and Jill Brooking, Regional Vice President of the Central Region of NFP Benefits Compliance. Kelly, the floor is yours.
00:01:26.200 - 00:01:33.040
Kelly Eckman: Alright, thanks, Amber, and welcome, everyone, to our March webinar on measurement periods.
00:01:33.280 - 00:01:37.929
Kelly Eckman: hopefully, the ACA's employer mandate and those lovely…
00:01:37.980 - 00:01:50.530
Kelly Eckman: 1095 forms that you guys have probably been working through this… these past couple months are fresh on your mind, so we wanted to go ahead and tackle this kind of difficult topic this month to make sure
00:01:50.530 - 00:01:58.639
Kelly Eckman: That you feel confident in what you've been doing, and then obviously that you're on a good path forward as you head into reporting for the next year.
00:02:02.720 - 00:02:10.320
Kelly Eckman: Okay, and as always, we're gonna have our disclaimer here. Again, what we're talking about today, it is for general guidance purposes only.
00:02:10.320 - 00:02:24.449
Kelly Eckman: We are not providing tax advice or legal advice. You need to seek your own counsel and guidance for those if you do need any legal or tax advice. And then the information we're talking about is current as of today.
00:02:24.720 - 00:02:32.059
Kelly Eckman: So here are our lovely pictures. Jill and I will be tackling this topic. I think it's actually a topic both Jill and I enjoy.
00:02:32.080 - 00:02:47.900
Kelly Eckman: Talking about and presenting, so hopefully you guys find this very useful. So our agenda. It looks pretty small, but I promise we've got a lot to cover. We're gonna start with a quick refresher on just some of the basics with the ACA's employer mandate.
00:02:47.960 - 00:03:00.350
Kelly Eckman: We're gonna dive into both the, initial and standard measurement periods. We're gonna tackle a very tricky topic in change in status and how employers, you know.
00:03:00.350 - 00:03:13.720
Kelly Eckman: need to work through eligibility considerations if someone changes from full-time to part-time, or vice versa. And then, as always, end with some key takeaways and resources that our team has.
00:03:14.830 - 00:03:22.939
Kelly Eckman: So, I'm gonna start us off talking through employer mandate basics, and really just one quick look at…
00:03:24.690 - 00:03:33.920
Kelly Eckman: the, you know, what is the ACA's employer mandate? Sometimes you'll hear this referred to as the employer shared responsibility provisions.
00:03:34.090 - 00:03:46.339
Kelly Eckman: So these rules have been around since 2015. So when we think about the ACA, we go back to 2010, but then specifically the employer mandate, and that requirement to offer coverage, and then obviously
00:03:46.340 - 00:03:55.319
Kelly Eckman: handle the reporting has been around since 2015, so we're at over a decade now that many employers have had to work through these rules.
00:03:55.350 - 00:04:11.740
Kelly Eckman: But, so what is the employer mandate? So it's going to apply to those employers with 50 or more full-time employees or equivalents. Employer size for this purpose, it's based on the previous calendar year. So even if you run a non-calendar year plan.
00:04:11.810 - 00:04:16.850
Kelly Eckman: The ACA is looking at your size in the previous calendar year.
00:04:16.980 - 00:04:26.179
Kelly Eckman: Also, if you are an employer that is part of a controlled group, for these purposes, all employees…
00:04:26.350 - 00:04:42.009
Kelly Eckman: within the entities in the control group are aggregated together. So, if you have two employers in the control group, one has 20 employees, one has 40, they're counted together, and that would be 60, and therefore, the mandate would apply.
00:04:42.430 - 00:04:45.249
Kelly Eckman: So, what does the mandate tell employers they need to do?
00:04:45.270 - 00:04:59.520
Kelly Eckman: Well, they need to offer coverage that meets minimum essential coverage, so kind of just your basic offerings that the health plan needs to offer. It needs to meet minimum value standards, and those are kind of
00:04:59.520 - 00:05:11.229
Kelly Eckman: set by actuaries. It needs to be affordable. This is always a tricky one, because what feels affordable to an employee is different than what the ACA says is affordable.
00:05:11.410 - 00:05:19.829
Kelly Eckman: So, the ACA is concerned with, affordability. They give employers 3 different ways to calculate that affordability.
00:05:19.950 - 00:05:32.760
Kelly Eckman: can either use a percent of W-2 wages, so doing that at the end of the year, a percentage based on the federal poverty level, or rate of pay, so actually looking at an hourly rate
00:05:32.820 - 00:05:50.670
Kelly Eckman: For, what an employee makes. So, 3 different ways that employers can calculate whether or not their coverage is considered affordable. And then employers must offer it to substantially all full-time employees. Substantially all is considered to be 95% of those full-time employees.
00:05:51.250 - 00:06:01.969
Kelly Eckman: And then coverage must be offered to dependent children up to age 26. Importantly, it is… that does… that mandate does not apply to spouses, only to children up to age 26.
00:06:01.990 - 00:06:12.309
Kelly Eckman: Now, whenever we're talking through the employer mandate and the ACA, this is just medical coverage. So we're not… these rules aren't going to apply to your other benefit offerings.
00:06:12.890 - 00:06:24.540
Kelly Eckman: And then full-time status, why are we all here today? Well, full-time status is determined either using the monthly or the look-back measurement method, and that's what we're really going to be focusing on today.
00:06:24.540 - 00:06:34.260
Kelly Eckman: So, the monthly measurement. So, this is kind of the simpler one, and we won't spend as much time talking about it today, but how does the monthly measurement method work?
00:06:34.370 - 00:06:52.370
Kelly Eckman: Well, so it's going to determine full-time status of those employees based on each calendar month. And so if an employee is averaging 30 hours per week, or 130 hours per month, they should have been offered coverage for that month. So every month, the employer is looking at it.
00:06:52.470 - 00:06:59.240
Kelly Eckman: So, what's the main advantage for the monthly measurement? Well, it's easier. It's more straightforward. We're just looking at
00:06:59.600 - 00:07:06.889
Kelly Eckman: does this employee meet, this criteria for the month? If yes, they should have been offered coverage. If no, they aren't.
00:07:07.780 - 00:07:26.769
Kelly Eckman: the employers that this is going to work best for are those with really clear lines between full-time and part-time employees. So, all of our full-time employees work 40 hours or more. All of our part-time employees are fewer than 20 hours. You really have a consistent line between,
00:07:26.920 - 00:07:29.010
Kelly Eckman: You know, that 30-hour mark.
00:07:29.820 - 00:07:44.700
Kelly Eckman: What are my disadvantages? Well, if the employer does have some employees that kind of flirt with that 30-hour-per-week line, maybe they have inconsistent schedules, or normally they don't hire part-time employees, but they did for some reason.
00:07:45.020 - 00:07:48.660
Kelly Eckman: What happens there is maybe I have someone who…
00:07:48.770 - 00:07:52.429
Kelly Eckman: You know, they meet the criteria because they're normally working 40 hours per week.
00:07:52.630 - 00:07:57.030
Kelly Eckman: But then they have a couple months where they step back and are only working
00:07:57.110 - 00:08:03.600
Kelly Eckman: 20 hours per week. Well, then all of a sudden, the employer has a situation where someone is eligible for one month.
00:08:03.610 - 00:08:18.270
Kelly Eckman: Then they're not eligible for the next month, so they need to be offered COBRA. Then maybe they go back over 30 hours a week, and they need to be offered coverage again. So kind of that coming on and off the plan is very difficult for an employer to administer.
00:08:18.460 - 00:08:29.300
Kelly Eckman: And so that's why the monthly measurement period, or monthly measurement method, really only works if you have those consistent employer, or employee schedules.
00:08:30.130 - 00:08:37.620
Kelly Eckman: And then the other thing is, you know, employers are supposed to be determining this before the month begins. That way they can make sure they offered coverage for that month.
00:08:37.720 - 00:08:51.080
Kelly Eckman: Again, if I'm gonna have someone who I'm not sure the kind of hours they're gonna work, that's really hard to do. So, for some employers, it makes complete sense, we only have full-time employees, they work 40 hours a week, great. But…
00:08:51.350 - 00:08:56.640
Kelly Eckman: If we have employees that are gonna have those varying schedules, that's where we're gonna look
00:08:56.830 - 00:09:00.379
Kelly Eckman: At the look-back, and that's what we're going to spend a lot of time on today.
00:09:00.550 - 00:09:06.459
Kelly Eckman: So right now, though, we're just starting with a super high level of what is the look-back. We're gonna dive into this in just a little bit.
00:09:06.640 - 00:09:13.519
Kelly Eckman: So, the look-back is going to determine that full-time status based on a predetermined period of time.
00:09:13.860 - 00:09:19.159
Kelly Eckman: And so if employees average that 30 hours a week, or 130 hours per month.
00:09:19.260 - 00:09:21.979
Kelly Eckman: During that time period, they should be offered coverage.
00:09:22.340 - 00:09:27.540
Kelly Eckman: So instead of looking at it month by month, we're looking at a longer period of time to determine that.
00:09:28.080 - 00:09:36.509
Kelly Eckman: So what's the advantage here? Well, if you have those employees where their hours vary, you have part-timers who sometimes work few hours, sometimes work a lot.
00:09:36.820 - 00:09:43.929
Kelly Eckman: Maybe I have employees that only come on for part of the year, that kind of thing. This is easier for them.
00:09:43.990 - 00:09:56.890
Kelly Eckman: We have lots of vendors out there that have, you know, ACA reporting modules, payroll providers. Most of your big payroll providers have modules for tracking those hours, so employers don't just have to sit there, you know, with a spreadsheet.
00:09:57.370 - 00:10:11.250
Kelly Eckman: But, what's the… what's the disadvantage? Well, if you're here, and you've been using lookbacks, you know that they're administratively burdensome. There are a lot of rules, a lot of quirks to these rules that we're going to get into a little bit later, and so it can be difficult.
00:10:11.250 - 00:10:17.610
Kelly Eckman: So, while it's necessary if you have those variable and part-time employees, it still can be difficult.
00:10:17.780 - 00:10:19.080
Kelly Eckman: to track.
00:10:19.880 - 00:10:29.549
Kelly Eckman: And then, obviously, you're also tracking both your new hires differently than you're tracking your ongoing employees. So again, just kind of that administrative burden is what you have to work through.
00:10:30.390 - 00:10:44.130
Kelly Eckman: So, our look-backs. Three main components of a look-back. You have your measurement period. So that's that period of time that you as the employer are gonna look at to determine the average hours that the employee worked.
00:10:44.890 - 00:11:00.750
Kelly Eckman: And then you have your administrative period. The administrative period is that time where you're going to analyze those hours. So you're going to say, okay, during that measurement period we had, the employees worked this many hours and are either considered full-time or part-time.
00:11:01.370 - 00:11:08.379
Kelly Eckman: And then that is when offers of coverage are made. So typically, you want that to coincide with when you offer open enrollment.
00:11:08.760 - 00:11:19.030
Kelly Eckman: And then the final part here, and again, we'll talk about these a little later too, is the stability period. So the stability period is that period of time
00:11:19.030 - 00:11:32.659
Kelly Eckman: where, you know, the employee has been determined to be full-time or part-time, and they are locked into that status as full-time or part-time for a specific amount of time. So even if their hours change, they are locked in
00:11:32.660 - 00:11:39.559
Kelly Eckman: to that status. In your stability period, we'll talk about it more. The minimum amount of time for that is 6 months.
00:11:39.590 - 00:11:45.130
Kelly Eckman: Or it'll be the same amount of time, the same duration as that look back.
00:11:45.400 - 00:12:01.850
Kelly Eckman: But we'll talk through these, and we've got some nice graphs to help out, too, in just a few more slides. But before we get to that, Jill's gonna walk us through, how we classify and how we look at employees as we're then determining these criteria.
00:12:03.510 - 00:12:07.759
Jill Brooking: Ellie Happy to join everybody today. Yes.
00:12:07.760 - 00:12:25.189
Jill Brooking: I don't know why, but Kelly and I like this topic. We might be odd. So, employee categories. As she was just saying, the two ways to determine if someone is eligible is the monthly and the look-back measurement methods.
00:12:25.300 - 00:12:31.750
Jill Brooking: So, you can use different methods for different categories, but the categories are
00:12:31.750 - 00:12:45.700
Jill Brooking: pretty specific, and they're pretty narrow. It's not like normally we say bonafide employment classifications, job title, whatever. But these are only four categories. Salaried and hourly.
00:12:45.840 - 00:12:51.639
Jill Brooking: Employees' primary place of employment in different states.
00:12:52.200 - 00:13:03.770
Jill Brooking: collectively bargained and non-collectively bargained, and those covered by different collective bargaining agreements. So if you don't have CBAs, you really only have two categories.
00:13:04.390 - 00:13:09.490
Jill Brooking: Next slide, please. And you'll notice it didn't say one of the categories was…
00:13:09.760 - 00:13:18.520
Jill Brooking: variable hour and part-time and full-time. It was salaried and hourly. So, you could have some…
00:13:18.630 - 00:13:24.330
Jill Brooking: Part-timers that are salaried, or you could have part-time and full-time hourly.
00:13:24.820 - 00:13:38.759
Jill Brooking: So, what is a full-time employee? Back in the old days, employers could define this themselves, or state law defined it, and that's still the case for some smaller employers.
00:13:38.760 - 00:13:48.190
Jill Brooking: But those with 50 or more, this is now defined by the ACA if you want to avoid a penalty. So, full-time employees has a very
00:13:48.330 - 00:14:02.490
Jill Brooking: Specific definition, again, for medical. It could be different, for your dental, your vision, your PTO policies, but for medical coverage to avoid a penalty. Full-time is defined as 30 hours a week.
00:14:02.640 - 00:14:06.460
Jill Brooking: For 130 hours per month.
00:14:07.560 - 00:14:20.110
Jill Brooking: The waiting period, if someone is full-time, cannot be more than 90 days. And I think everybody knows that now, and that's standard. Full-time employees
00:14:20.520 - 00:14:35.129
Jill Brooking: they're still measured, like, in the background. They would still have hours, because again, remember, the categories where you're measuring is salaried or hourly. It's not full-time or part-time.
00:14:35.330 - 00:14:43.280
Jill Brooking: So, when you first get an employee, are they reasonably expected to work full-time hours?
00:14:43.530 - 00:14:54.760
Jill Brooking: And then part-time employees, of course, those working less than 30 hours a week, or 130 hours per month, and they would be,
00:14:55.060 - 00:15:12.279
Jill Brooking: Either on the monthly measurement, offered coverage for the month, or most employers, if they have a significant part-time population, would use the look-back measurement, and they would not be eligible for coverage until they earned it at the end of their initial measurement period.
00:15:13.320 - 00:15:14.640
Jill Brooking: Next slide.
00:15:15.010 - 00:15:17.169
Jill Brooking: And I love this up and down graphic.
00:15:17.500 - 00:15:35.820
Jill Brooking: Kelly chose. That's what a variable hour employee is. Sometimes they're going to be more than 30 hours, and sometimes they're going to be less, right? Classic example are your PRNs, restaurant workers, anything really in retail where somebody might be picking up more ships
00:15:36.080 - 00:15:41.049
Jill Brooking: And you don't really know how they're going to work out when you first hire them.
00:15:41.300 - 00:15:46.190
Jill Brooking: So, variable hour employee. Again, when we hire them.
00:15:46.430 - 00:16:00.720
Jill Brooking: Are they reasonably expected to work full-time hours or part-time? We don't know their schedule, we don't know what they're gonna do. So, this is perfect for the look-back, right? We're gonna average them over a period of time.
00:16:00.910 - 00:16:03.940
Jill Brooking: So, things to think about when you're…
00:16:04.490 - 00:16:08.570
Jill Brooking: classifying someone as variable hour.
00:16:09.620 - 00:16:26.989
Jill Brooking: what was the per… was this a existing position, and it's a replacement hire? What, did that position look like before with the hours? Or is this a new position? How is it scoped out on the job description? How is it advertised?
00:16:27.080 - 00:16:46.489
Jill Brooking: Yeah, so if this is, like, again, if you're retail, you know that most of your servers are going to be, variable hour, probably. So just think about historically what that looks like. And one thing that we see, a little bit, not so much anymore, but sometimes we'll see it.
00:16:46.650 - 00:17:02.460
Jill Brooking: Some employers want to say, well, all of my employees are variable hour because they don't want to offer coverage to anyone for the first year. You can't really do that. It has to be justified, right? Like.
00:17:02.620 - 00:17:14.690
Jill Brooking: If all… if 90% of your employees end up being full-time employees at the end of the measurement period, you need to look at your criteria for determining if someone's full-time, part-time, variable hour.
00:17:15.369 - 00:17:16.650
Jill Brooking: Next slide.
00:17:18.050 - 00:17:23.220
Jill Brooking: seasonal employees. So, there is no…
00:17:24.940 - 00:17:34.100
Jill Brooking: So, seasonal… when you think about seasonal, I like to say… the slides, I won't always read them word for word, but I like to say, is the work
00:17:34.240 - 00:17:39.430
Jill Brooking: The nature of the work, or is the need seasonal?
00:17:39.680 - 00:17:44.620
Jill Brooking: So, seasonal might be…
00:17:44.670 - 00:17:55.070
Jill Brooking: an accounting firm. The first quarter of the year might be their season. They're busier because tax time comes in April. That's going to be their season.
00:17:55.070 - 00:18:09.149
Jill Brooking: So the… the need of the work. The nature of the work might be, landscaping. They're only, they're in an area of the country where they're only doing landscaping 4 or 5 months a year.
00:18:09.270 - 00:18:16.260
Jill Brooking: So, seasonal, is kind of an exception. So you're looking at the full-timers, the part-timers,
00:18:16.400 - 00:18:23.929
Jill Brooking: variable hour and seasonal. So, seasonal means their annual employment does not exceed 6 months.
00:18:24.300 - 00:18:40.000
Jill Brooking: And they work at the same time every year. So, again, like the accountants, they're always usually hired in December or January. They're only working 4 or 5 months, and then they don't,
00:18:40.000 - 00:18:46.400
Jill Brooking: work for you anymore. If they are truly seasonal, you can put them in a look-back measurement period.
00:18:46.840 - 00:18:52.599
Jill Brooking: And only offer them coverage if they're still employed there, and…
00:18:52.730 - 00:19:04.509
Jill Brooking: they've earned full-time hours. Remember that, in the basics, they said, that you can have measurement periods up to 12 months.
00:19:04.880 - 00:19:18.619
Jill Brooking: So it kind of… you have to look at what's your goal? Do you want to… if your goal is to have the least amount of eligible employees, then you, might want to have a longer measurement, 12 months.
00:19:19.100 - 00:19:30.810
Jill Brooking: And you would not have as many. So if a seasonal employee is not working for more than 6 months, obviously they're not going to qualify for coverage. But if your goal is to maybe
00:19:30.930 - 00:19:36.499
Jill Brooking: attract more talent than your competitor, you might want a shorter measurement.
00:19:36.730 - 00:19:44.690
Jill Brooking: Period. So you're catching more, of those, and only offering coverage to those who are truly working full-time hours.
00:19:45.020 - 00:19:46.950
Jill Brooking: Interns.
00:19:47.100 - 00:19:57.470
Jill Brooking: A lot of employers think there is an exception for interns. There's not. There's an exception for seasonal. There's not an exception for interns.
00:19:57.760 - 00:20:13.940
Jill Brooking: So, if you have interns that are seasonal, great! You can treat them like the seasonal above and put them in a look-back measurement, period. But you have to look at when you're hiring the interns.
00:20:14.290 - 00:20:20.990
Jill Brooking: Or is it the same time period every year? Are they working more than 6 months?
00:20:21.370 - 00:20:23.859
Jill Brooking: So let's say…
00:20:23.880 - 00:20:33.549
Jill Brooking: We're hiring interns in different divisions or different departments all times of the year. It's just based on school breaks.
00:20:33.550 - 00:20:45.920
Jill Brooking: So, it might be, one, intern works in the summertime, and then you're hiring another one in September. That's not going to be seasonal. They have to be hired at the same time every year.
00:20:46.100 - 00:20:51.600
Jill Brooking: And they can't work more than 6 months. So if they truly are seasonal, they can work full-time hours.
00:20:51.740 - 00:20:55.789
Jill Brooking: And you would just put them in a look-back measurement period.
00:20:56.160 - 00:20:58.579
Jill Brooking: Hopefully that made sense. Next slide.
00:21:01.850 - 00:21:16.290
Jill Brooking: So, rehires. What do we do if they, come back? So, they… they quit, they're gone, and then they come back. Well, there's a rehire rule called the 13-week rule.
00:21:16.470 - 00:21:23.429
Jill Brooking: And, if somebody leaves and you re-hire them within 13 weeks.
00:21:23.460 - 00:21:38.730
Jill Brooking: Their eligibility status continues, so if they were formally, full-time and offered coverage, and they come back, you, cannot apply a new waiting period to them. They came back as full-time, they just continue on.
00:21:38.730 - 00:21:44.319
Jill Brooking: If they were in, let's say, an initial measurement period, they worked for you for
00:21:44.620 - 00:21:59.239
Jill Brooking: 4 or 5 months, they were gone for a month, and then they came back, you can continue the same measurement period. You would not start a new one. But if they are rehired after 13 weeks.
00:21:59.290 - 00:22:04.849
Jill Brooking: Then you would treat them brand new, and you would look at them all over again, starting from zero.
00:22:05.100 - 00:22:17.610
Jill Brooking: There are special rules for educational institutions, and if they work for you for fewer than 13 weeks, we're not going to go into that. We're already pretty much in the weeds on this one, so…
00:22:17.610 - 00:22:28.970
Jill Brooking: We'll save that, and we do have a publication, the ACA Employer Mandate Full-Time Employees, so if you don't already have that, ask your advisor for that.
00:22:29.470 - 00:22:40.709
Jill Brooking: And then, this is one of my favorite subtopics of this one, employees from a staffing agency. So, some of you might actually be a staffing agency yourself.
00:22:40.880 - 00:22:45.939
Jill Brooking: Or you may, use one. So,
00:22:46.910 - 00:23:02.190
Jill Brooking: This standard is the common law employer standard. So, are they common law employees of you, or are they common law… so, I will call it the recipient organization if you are, using
00:23:02.190 - 00:23:08.269
Jill Brooking: employees from a staffing agency, so I'll call that the recipient organization, and then the staffing agency.
00:23:08.420 - 00:23:09.540
Jill Brooking: So…
00:23:09.580 - 00:23:27.319
Jill Brooking: Even though a worker might be receiving a paycheck from a staffing agency, that doesn't… that's not the only determining factor. That doesn't mean that they are automatically the, employee of the staffing agency.
00:23:27.320 - 00:23:34.770
Jill Brooking: You have to look at all these considerations. Behavioral control, financial control, relationship control.
00:23:34.950 - 00:23:52.910
Jill Brooking: So, who's providing the tools? Who's providing the training? Who is doing the payroll functions? If that person's not doing a good job, does the recipient organization have the right to say, no, get rid of them, they're not performing well?
00:23:53.200 - 00:24:03.249
Jill Brooking: So, interestingly, in the preamble to the final regulations, the DOL discussed that
00:24:04.000 - 00:24:21.740
Jill Brooking: Typically, this isn't going to be all the time, but typically, the common law employer, in the standard relationship of recipient organization and a staffing agency, the recipient organization is going to be the common law employer of that worker.
00:24:21.740 - 00:24:32.800
Jill Brooking: Think about it, you're the one determining how they do the job, when they do the job, what time they get there, when they leave, if they're not doing a good job, you can say, no, you're gone, give me somebody else.
00:24:33.400 - 00:24:37.980
Jill Brooking: Typically, you have that control. You want to look at your contracts.
00:24:38.130 - 00:24:53.790
Jill Brooking: So, if you're the staffing agency, or if you're using workers from there, look at your contracts, because it always can be contracted differently. You want to look at two things. One, who is responsible for offering coverage to that worker?
00:24:53.950 - 00:24:58.989
Jill Brooking: And two, who's reporting them on the 1095 fees?
00:24:59.270 - 00:25:07.940
Jill Brooking: Make sure that you look at those contracts. I've seen contracts that are older than 2015, and it's not even discussed in the contract.
00:25:08.220 - 00:25:11.970
Jill Brooking: So, you definitely want to review those. Next slide.
00:25:14.500 - 00:25:16.969
Jill Brooking: Oh, and I'm out! Back to you, Kelly.
00:25:16.970 - 00:25:21.460
Kelly Eckman: Alright, and today I learned that Jill loves talking about staffing agencies.
00:25:21.460 - 00:25:22.779
Jill Brooking: I do!
00:25:22.780 - 00:25:27.329
Kelly Eckman: I didn't know that, so that's good to… That's good to know here.
00:25:27.640 - 00:25:43.500
Kelly Eckman: All right, so now we're really going to start getting into the weeds. All that before was kind of our overviews, now we're going to get into the weeds of these measurement periods we were talking about. Again, and here we're really diving into that look-back, because as we talked about, that's the confusing one.
00:25:43.620 - 00:25:50.080
Kelly Eckman: We hit on some of this before, but we want to put some nice graphs in here to help you as well.
00:25:50.480 - 00:25:57.170
Kelly Eckman: So, our initial measurement period. So, this is for your new hires only.
00:25:57.330 - 00:26:00.830
Kelly Eckman: So, we talked about that measurement, that look back.
00:26:00.840 - 00:26:17.959
Kelly Eckman: So, for new hires, it's gonna be based on one of two dates. Either employers can use the date of hire to start that initial measurement period, or the first of the month following date of hire. Those are the two options. And I think often employers will do first of the month…
00:26:18.100 - 00:26:26.369
Kelly Eckman: Following date of hire, just so that they're only running potentially 12 initial measurement periods instead of, you know, 1 per date of hire.
00:26:26.640 - 00:26:34.500
Kelly Eckman: The initial measurement period is going to be a period of time between 3 and 12 months.
00:26:34.880 - 00:26:48.140
Kelly Eckman: And that's that time where, again, you're looking at what kind of hours they worked during that time. Then we have our stability period. Again, that's the amount of time that someone is locked into that status once we've determined full-time or part-time.
00:26:48.190 - 00:27:04.470
Kelly Eckman: Now, for the initial measurement period, the stability period must be the longer of either 6 months or whatever that… whatever the standard stability period is. So, even if you said, oh, we want to give people coverage, you know, as soon as we can.
00:27:04.470 - 00:27:08.629
Kelly Eckman: So you're using an initial look-back of 3 months.
00:27:08.630 - 00:27:28.380
Kelly Eckman: that initial stability period may need to be 6 months. It couldn't be 3 months. So, sometimes those times can get a little wonky. And again, as Jill talked about earlier, you know, your waiting period cannot exceed 90 days, and that's why administrative periods are limited to 90 days. But…
00:27:28.600 - 00:27:41.400
Kelly Eckman: It gets a little trickier for our new hires in these initial measurement periods. The combined initial measurement period plus administrative period cannot exceed 13 months.
00:27:41.650 - 00:27:43.240
Kelly Eckman: After they were hired.
00:27:43.450 - 00:27:48.030
Kelly Eckman: So, essentially, if an employer wants to do a 12-month
00:27:48.160 - 00:28:04.700
Kelly Eckman: initial measurement period, which is pretty common for new hires, then that administrative period would only be 1 month, so that that combined time does not exceed 13 months. And again, that's where working with, you know, the payroll software or your VIN admin software
00:28:05.270 - 00:28:10.689
Kelly Eckman: It's helpful, because it's gonna help you track and keep those dates together.
00:28:10.720 - 00:28:21.379
Kelly Eckman: So, we're gonna walk through an example, because sometimes that makes it easier. So, in our example, we're going to have an initial measurement period, and this employer uses a 12-month
00:28:21.380 - 00:28:33.159
Kelly Eckman: initial measurement period, which again, is pretty common. So we hire, someone, Steve, he's hired February 1st, and he's only hired to work 25 hours per week, so hired into a part-time
00:28:33.160 - 00:28:43.879
Kelly Eckman: position. So, Steve is going to be placed into a 12-month initial measurement period, so it's going to run from February through the end of the next January.
00:28:44.530 - 00:29:03.660
Kelly Eckman: So, there's his 12 months. So, what is the administrative period? Well, we know our initial measurement period plus admin cannot exceed 13 months, so we're going to have a 1-month administrative period, and that administrative period is going to run that next February, so February of year 2.
00:29:04.370 - 00:29:11.770
Kelly Eckman: And then, we're gonna determine, you know, what kind of hours did Steve work during that initial measurement period.
00:29:11.790 - 00:29:25.339
Kelly Eckman: And that's what we're doing during the administrative period. So, in our example here, Steve actually averaged more than 30 hours per week during that initial measurement period. So even though he was hired to work 25 hours a week.
00:29:25.340 - 00:29:37.339
Kelly Eckman: Obviously, he worked more hours than that during that initial measurement period. So, as the employer's looking at his hours during that administrative period in the following February.
00:29:37.350 - 00:29:47.800
Kelly Eckman: they determine he actually is considered full-time in the eyes of the ACA, because he averaged 30 hours or more. So, that means he is going to be eligible
00:29:47.840 - 00:29:53.839
Kelly Eckman: for medical coverage beginning on March 1st, because again, we can't exceed 13 months.
00:29:53.890 - 00:30:08.130
Kelly Eckman: And then his stability period is going to run 12 months, and that's because, again, we had a 12-month look back, and so we have to have a 12-month stability period. So he's locked into…
00:30:08.210 - 00:30:16.179
Kelly Eckman: eligible status for medical through the following February after that, so think about that kind of year 3.
00:30:16.530 - 00:30:36.090
Kelly Eckman: So, even if, during that stability period time, his hours drop, so maybe he drops back to 25 like he was hired, or even drops down to 20, it doesn't matter. He remains eligible through that initial stability period, because the look-back determined he was eligible.
00:30:36.950 - 00:30:54.239
Kelly Eckman: And then, once his initial measurement period is up, he's gonna move from initial measurement period into what is known as the standard measurement period, and that's used for ongoing employees. And we're gonna talk through that interaction, on these next slides.
00:30:55.660 - 00:31:11.020
Kelly Eckman: So, our standard measurement period. So, this is what's used for ongoing employees. It's always running in the background, like Jill said. You know, even with new hires, they're gonna overlap between the initial and the standard measurement
00:31:11.020 - 00:31:23.049
Kelly Eckman: Period. So they're always kind of running in the background, whether we realize it or not. So the standard measurement period, again, we're gonna have a measurement period, or a look back, of 3 to 12 months.
00:31:23.180 - 00:31:32.779
Kelly Eckman: It's gonna be run on the same time each year, so instead of being tied to a date of hire, it's gonna run on the same cadence each year.
00:31:33.370 - 00:31:46.549
Kelly Eckman: Again, our administrative period, cannot exceed 90 days because of those waiting period rules. And then your stability period, again, the longer of 6 months, or the length of that standard stability… or, yeah.
00:31:46.790 - 00:31:55.890
Kelly Eckman: the measurement period. So, again, typically you're gonna have, you know, a 6 and 6 or a 12 and 12, because you're gonna have parity between those.
00:31:56.410 - 00:32:00.299
Kelly Eckman: So we're gonna look at an example here in our lovely little chart.
00:32:00.750 - 00:32:08.660
Kelly Eckman: So, in this case, again, we're looking at an employer that uses a 12-month look-back. That's, again, a very common
00:32:08.830 - 00:32:14.889
Kelly Eckman: For employers to use the 12-month look-back, and here we're assuming this is a calendar year medical plan.
00:32:15.120 - 00:32:21.559
Kelly Eckman: So, their standard measurement period is gonna run from November through October.
00:32:21.840 - 00:32:29.740
Kelly Eckman: And so we're running a 12-month period. So you can… if you look at the graph here, that's going to be our yellow, the standard measurement period.
00:32:30.660 - 00:32:34.779
Kelly Eckman: And then our administrative period, so once our measurement period is over.
00:32:35.060 - 00:32:38.719
Kelly Eckman: We need time to analyze those hours, to look and see
00:32:38.910 - 00:32:54.409
Kelly Eckman: who worked full-time hours, who worked part-time hours, and make that offer of coverage. You always want to make sure that the admin period, the administrative period, coincides with open enrollment. Sometimes we'll answer questions and the employer's running…
00:32:54.620 - 00:32:59.239
Kelly Eckman: Let's say a look back for a calendar year plan that runs January through December.
00:32:59.310 - 00:33:13.909
Kelly Eckman: So then their administrative period is January and February, which that doesn't line up, because you've already had open enrollment. You've already had to offer coverage to people. So you always want to make sure when you're mapping this out that that administrative period
00:33:13.910 - 00:33:24.329
Kelly Eckman: coincides with when you normally run open enrollment. And so if you normally run an open enrollment, let's say, in October, then you have to adjust those dates.
00:33:24.460 - 00:33:29.770
Kelly Eckman: Because you want to make sure you're encompassing open enrollment with that administrative period.
00:33:30.100 - 00:33:50.059
Kelly Eckman: So in this example, we have… we'll just call it 2 months for ease. Obviously 2 months is less than 90 days, so we're okay. So that's when the employer's gonna determine who is full-time, who's not, we're gonna make that offer of coverage. Once we make that offer of coverage, those employees are locked into that status as eligible or not.
00:33:50.350 - 00:33:56.200
Kelly Eckman: during that stability period. And you want your stability period when you're running a 12-month
00:33:56.450 - 00:34:10.979
Kelly Eckman: look back in this example, you want that to coincide with your plan year. So, we said we have a calendar year plan year here, so my stability period is going to run from January to December. That way, it makes it as easy as possible
00:34:11.110 - 00:34:14.660
Kelly Eckman: To have someone eligible for our normal plan year.
00:34:15.110 - 00:34:29.879
Kelly Eckman: So again, we've got 12 months here because that's what we chose. So this is a very standard example for your calendar year plans, and I'm guessing many of you attending today have a standard measurement period that looks very similar to this.
00:34:32.110 - 00:34:44.469
Kelly Eckman: Now, sometimes we will get employers who want something shorter, whether it's, you know, maybe they have a lot of turnover, or a lot of hours that vary, and so they… they want to be, you know.
00:34:44.630 - 00:34:54.169
Kelly Eckman: not letting someone stay on the plan for 12 months if their hours are going to be dropping. So, sometimes you'll see employers do, let's say, a 6-month
00:34:54.469 - 00:35:01.280
Kelly Eckman: measurement period. Again, this is going to be a little more administrative work for the employer, but it is something you can do.
00:35:01.410 - 00:35:07.659
Kelly Eckman: So, in this example, we're running a 6-month standard measurement period, so you're actually gonna have 2…
00:35:08.150 - 00:35:13.899
Kelly Eckman: Essentially, during a 12-month period. So, measurement period 1, running December through May.
00:35:14.030 - 00:35:19.790
Kelly Eckman: And so then you're gonna have your admin period in June. So during June, that's when the employer's gonna look at
00:35:19.990 - 00:35:33.940
Kelly Eckman: Average hours from December through May, and make those offers of coverage. The offer of coverage is only going to be made for 6 months in this example. So employees are going to run, be in that stability period from July through December.
00:35:34.410 - 00:35:41.930
Kelly Eckman: And then we do it all over again. So then for the other 6 months, we're looking at hours worked during June and November.
00:35:42.170 - 00:35:48.080
Kelly Eckman: We're… analyzing hours in December, and then locking them into that status for January through June.
00:35:48.610 - 00:36:05.730
Kelly Eckman: So, in our example with Jane here, during that first measurement period, she averaged 134 hours per month. So, she was considered eligible, she was offered coverage in June, and then she's locked into that eligible status for July through December.
00:36:06.580 - 00:36:15.789
Kelly Eckman: And then, in the… and again, it doesn't matter if during July through December her hours dropped, she was locked into eligible status.
00:36:15.800 - 00:36:35.030
Kelly Eckman: But, in the background, we're also running that measurement period number 2 to determine if she will be offered coverage during that next admin period in December. So it's always running in the background, and as you can see, running it for just 6 months is going to potentially bring someone kind of on and off the plan.
00:36:35.540 - 00:36:41.100
Kelly Eckman: And here's the example of that. This graph may make it a lot easier to understand.
00:36:41.270 - 00:36:52.230
Kelly Eckman: Because you can see here that, you know, we have our yellow with our measurement period and our admin, but then when we look on the second row down, we see that standard stability period 1,
00:36:52.230 - 00:37:08.410
Kelly Eckman: is overlapping with the measurement period, too. So they're always kind of overlapping and running back and forth with each other. So that's why, again, a good tracking software is really important to make sure, especially if you're doing a shorter measurement period like this.
00:37:08.760 - 00:37:21.840
Kelly Eckman: Now, we mentioned this at the beginning, I said, well, you know, when someone's moving from a new hire status to an ongoing employee, we have kind of the interaction between both the initial measurement period and that standard measurement period.
00:37:22.340 - 00:37:28.430
Kelly Eckman: And so, again, we've got, in this example, we have Mike, and he's in his initial measurement period in pink.
00:37:28.610 - 00:37:42.310
Kelly Eckman: But, you also see that standard measurement period that the employer is using for ongoing employees in yellow. So even though Mike is running his own initial measurement period, in the background, we also have
00:37:42.310 - 00:37:58.569
Kelly Eckman: that, employer standard measurement period. And so, it can get kind of confusing understanding that, okay, well, Mike could be locked in through, let's say, April, but then if he didn't work enough hours, his coverage would end in April, and he'll be measured during the next
00:37:58.620 - 00:38:11.309
Kelly Eckman: measurement as well. So it's always kind of running in the background. I know it can be kind of difficult to understand, but that's why, again, that tracking software is really important to understand just the basics here, not even the nuanced situations.
00:38:12.210 - 00:38:23.030
Kelly Eckman: Jill's now going to take us through some of these change in status rules, and where it can get even more confusing, kind of understanding how these measurement periods work with each other.
00:38:23.160 - 00:38:31.389
Jill Brooking: Even more confusing, I love that. Yes, it just keeps getting better and better, doesn't it? So, as Kelly was going through those, I…
00:38:31.390 - 00:38:46.930
Jill Brooking: I just wanted to maybe mention, like, common mistakes that I see, so if this sounds familiar, I'm saying they're common, so don't feel bad. Just reach out to, your advisor and your account team, and we can take care of it.
00:38:46.930 - 00:38:51.930
Jill Brooking: But, as Kelly said, not having the same length
00:38:52.070 - 00:39:01.790
Jill Brooking: So maybe, sometimes I'll see, like, somebody has a 6-month measurement and a 12-month stability.
00:39:01.880 - 00:39:18.420
Jill Brooking: 6-month measurement means you get a six-month stability, and you're doing that twice a year. You don't get to pick the 6 months, and then, like, oh, these are our 6 non-busiest months, and then we're gonna lock them out for 12 months. It has to generally be the same.
00:39:18.520 - 00:39:21.110
Jill Brooking: And then another,
00:39:21.300 - 00:39:39.600
Jill Brooking: thing. Remember, Kelly said, and you might… if this is your first time hearing about all this, it helps to hear it 3 or 4 times, right? So, Kelly made a difference between initial measurement and initial stability, and standard measurement
00:39:39.760 - 00:39:41.830
Jill Brooking: Standard stability.
00:39:42.280 - 00:39:50.940
Jill Brooking: So, initial measurement and initial stability is based on that individual's unique hire date.
00:39:51.740 - 00:40:10.320
Jill Brooking: the standard measurement, standard stability, is going to be the same for all of your ongoing employees. And she gave you that example of where somebody was new and in initial, and then they dropped down to, the standard.
00:40:10.320 - 00:40:22.810
Jill Brooking: And so, something I'll see, let's say you have a calendar year plan. So you're going to have open enrollment in November, right? And then you will… the coverage will be effective in January.
00:40:23.230 - 00:40:32.710
Jill Brooking: So, let's say that Ray, started for you in June. You can't measure Ray's hours
00:40:32.710 - 00:40:40.800
Jill Brooking: June to October, and then decide if he's going to be eligible for coverage in January through December of the next year.
00:40:40.800 - 00:40:53.460
Jill Brooking: He has to do his initial measurement and initial stability, right? So, any new hires wouldn't be in that cycle for the January open enrollment. So, that's some bonus material.
00:40:53.610 - 00:40:55.909
Jill Brooking: Okay, so…
00:40:56.110 - 00:41:09.850
Jill Brooking: I love the chart you're looking at right now. It is in our publication that I mentioned earlier. It's, like, the last page, I think, Appendix A. I, myself, will refer to this
00:41:09.940 - 00:41:23.979
Jill Brooking: all the time. Whenever somebody asks me a change in status question, I'm pulling out this chart. It's just easier for me, so I learn visually, it just makes sense to me, this way. So…
00:41:24.040 - 00:41:35.340
Jill Brooking: I'm going to go through some examples, and then I'll flip back to the chart, so whether you get it by the picture or the words, we've got it both ways. So, if you want to go to the first example, Kelly.
00:41:36.480 - 00:41:47.240
Jill Brooking: Thank you. So, Jenny. And of course, now I'm thinking of the 80s song, Jenny, Jenny. But anyway. So, Jenny was hired in January to work full-time hours.
00:41:47.620 - 00:41:55.030
Jill Brooking: And then, just a few months later, beginning in May, she moved to a part-time position.
00:41:55.210 - 00:42:04.779
Jill Brooking: And so this was a bona fide change from full-time to part-time. And the part-time position at this company, they would not be benefits eligible.
00:42:05.010 - 00:42:16.309
Jill Brooking: And they used the look-back measurement method. But Jenny was hired as full-time, and she was offered coverage following the waiting period, right? But remember.
00:42:16.470 - 00:42:31.700
Jill Brooking: we said, for the first year, even if they're full-time, we're still measuring their hours, and we're still kind of using that monthly measurement method for the first year. So, if you want to flip back to the chart…
00:42:32.520 - 00:42:42.750
Jill Brooking: Kelly, thank you. Okay, so we start off with employee has a change. So, what did Jenny do? She went from full-time to part-time, so move to the left.
00:42:43.040 - 00:42:56.829
Jill Brooking: And then, was Jenny offered coverage immediately upon hire, after any waiting period, and continuously covered since? Yes, she was. Again, moved to the left. Thank you, Kelly, with the arrow.
00:42:57.220 - 00:43:03.070
Jill Brooking: Was Jenny employed for an entire standard, standard, not initial.
00:43:03.070 - 00:43:18.539
Jill Brooking: standard measurement period. No, she just got here 4 months ago. So we go down to no, coverage may be terminated at the end of that month in which status changed. So she's going to lose coverage in May?
00:43:18.540 - 00:43:24.240
Jill Brooking: And we will offer her COBRA, because she had a reduction in hours.
00:43:25.070 - 00:43:27.569
Jill Brooking: Great, now let's move to Example 2.
00:43:28.540 - 00:43:30.989
Jill Brooking: Now, we're talking to Anna.
00:43:31.210 - 00:43:40.870
Jill Brooking: And Anna was hired in January to work part-time hours, so we had no reasonable expectation that she was going to work full-time hours.
00:43:41.150 - 00:43:43.489
Jill Brooking: She was supposed to work 20 hours a week.
00:43:43.810 - 00:43:57.659
Jill Brooking: But in April, she moves to a full-time position. Maybe she… we really liked her, she's doing a great job, and we're like, hey, we got this other role over here for you. We think you'd be great. It's full-time, and it's usually benefits eligible.
00:43:57.890 - 00:44:16.279
Jill Brooking: And we use the look-back measurement method. Since Anna was hired as part-time, she would still be measured in her initial measurement period that began in February, and typically runs 12 months with that one admin, one month admin period.
00:44:16.460 - 00:44:21.080
Jill Brooking: Well, since she changed to the full-time position in April.
00:44:21.240 - 00:44:30.640
Jill Brooking: What does that mean? So, now flip back to… Kelly, I'm so sorry. I told you to drive, and now I'm, like, making you do all this. Okay, so, Anna.
00:44:30.970 - 00:44:35.079
Jill Brooking: So we start at the top again. Employee has a change in employment status.
00:44:35.190 - 00:44:41.680
Jill Brooking: Anna was hired part-time, and then we moved her over to a full-time position, so now we're going to the right.
00:44:42.300 - 00:44:56.160
Jill Brooking: Was Anna determined to be part-time during a measurement period? No, she was still in there. So we dropped down to the right again. We… she was still in the initial measurement, she had not completed one.
00:44:56.270 - 00:45:13.509
Jill Brooking: Coverage must be offered… oh, sorry, I had a pop-up on my screen. There. Coverage must be offered by the first day of the fourth month following the change in status for the first of the month following. So, go back to Anna.
00:45:14.500 - 00:45:26.509
Jill Brooking: slide, thank you. So, change to a full-time position in April means the employer must now offer her coverage no later than the first date of the fourth month following April.
00:45:27.350 - 00:45:29.030
Jill Brooking: Clear as mud, right?
00:45:29.410 - 00:45:32.490
Jill Brooking: Shall we do another example? Let's keep going.
00:45:33.350 - 00:45:35.370
Jill Brooking: Tyler, that's my nephew's name.
00:45:35.580 - 00:45:40.199
Jill Brooking: Okay, so Tyler was hired in 2022. He's worked for us for a while.
00:45:40.360 - 00:45:42.809
Jill Brooking: And he works full-time hours.
00:45:43.150 - 00:45:55.259
Jill Brooking: And he was hired in at full-time hours. Beginning in May of this year, he moves to a part-time position that would normally not be benefits eligible if he was hired into that.
00:45:55.470 - 00:45:58.890
Jill Brooking: And we use the look-back measurement method.
00:45:59.010 - 00:46:06.230
Jill Brooking: So, Tyler has already completed at least one standard measurement period, right? He's been here for 4 years!
00:46:06.500 - 00:46:15.259
Jill Brooking: So, he continues to be measured via the look-back measurement method. Remember, we said he's full-time, but it's still going in the background, right?
00:46:16.100 - 00:46:28.930
Jill Brooking: So, what do we do? Employers should offer coverage at the end of the stability period. So let's switch back to… sorry, 3 slides back now, silly.
00:46:29.320 - 00:46:36.400
Jill Brooking: Okay, so I would say that this is one of the most common mistakes
00:46:36.630 - 00:46:48.679
Jill Brooking: that we see. This is the one that, Kelly just had, an FAQ in Compliance Corner on. So, let's go to the top again. Employee has a change in employment status.
00:46:48.820 - 00:46:53.699
Jill Brooking: Changed from full-time to part-time, Tyler was hired 4 years ago as full-time.
00:46:54.290 - 00:47:05.199
Jill Brooking: Did… was Tyler offered coverage immediately upon hire after any waiting period? Yes, he has been offered coverage continuously since then, so we dropped down to the left. Yes.
00:47:05.470 - 00:47:20.950
Jill Brooking: Was the employee employed for an entire standard, standard measurement period? Yes, he's been here 4 years. Coverage may be terminated on the first day of the fourth month following the change in status.
00:47:21.450 - 00:47:23.830
Jill Brooking: So, going back to the old days.
00:47:24.010 - 00:47:27.269
Jill Brooking: We would have terminated him at the end of the month, right?
00:47:27.560 - 00:47:35.220
Jill Brooking: He just switched from full-time to part-time, so this is what we see still today a lot.
00:47:35.540 - 00:47:37.720
Jill Brooking: So, if this… if…
00:47:37.900 - 00:47:51.020
Jill Brooking: the facts match. Tyler's here, and it's an ongoing employee, and they've been employed for a while in full-time, and they're moving to part-time. It's the first of the month following 4 months.
00:47:51.360 - 00:48:06.169
Jill Brooking: after the change in status. And so, I mean, obviously, if he… if the situation was that he terminated employment, this would not apply, right? We're talking about somebody who's switching, had a change in status.
00:48:06.300 - 00:48:17.110
Jill Brooking: from full-time to part-time. So, the first of the fourth full month, again, offer COBRA and a reduction of hours.
00:48:17.560 - 00:48:34.520
Jill Brooking: For, the sake of time, I'm going to skip the fourth one and, say that, we have the chart, so you guys can go look. Won't that be fun? Now you have a fact pattern, and then you can go check the chart, the flow chart for yourselves.
00:48:35.180 - 00:48:36.340
Jill Brooking: Okay, thank you.
00:48:39.400 - 00:48:51.329
Kelly Eckman: Alright, thanks, Jill. Yeah, and as Jill said, that appendix, that chart that she talked about, you know, we use a ton ourselves.
00:48:51.760 - 00:48:57.620
Kelly Eckman: Like, we use our resources ourselves, so if we're fielding questions from
00:48:57.680 - 00:49:11.569
Kelly Eckman: you know, clients and account teams, we're looking at these resources, to help ourselves, because while I'd say Jill and I speak pretty fluent measurement period, it's still really confusing.
00:49:11.630 - 00:49:25.740
Kelly Eckman: And like Jill said, if this is maybe your first time kind of hearing some of this, or you're newer to your role, or having to deal with, you know, measurement periods for the first time, it's gonna take a while to kind of get some of these
00:49:26.050 - 00:49:38.919
Kelly Eckman: rules down. Like Jill said, the one we hear the most is moving from full-time to part-time, and employers just assume, okay, they moved to part-time, we're canceling their coverage.
00:49:39.640 - 00:49:49.540
Kelly Eckman: And for the reasons that she walked through on that chart, that is not the right way to do it. So if you have been doing it that way, again, it's common.
00:49:49.930 - 00:50:06.610
Kelly Eckman: But you definitely want to, you know, work with your vendor, the payroll provider, reach out to your advisor or consultant for some of these resources to make sure that you can kind of get that ship righted as you're heading into the next year.
00:50:07.030 - 00:50:10.380
Kelly Eckman: Okay, so what are our takeaways from today?
00:50:10.570 - 00:50:18.709
Kelly Eckman: Maybe I should have just said measurement periods are confusing, because that's probably a takeaway that a lot of you have today, and that is very valid.
00:50:18.880 - 00:50:30.290
Kelly Eckman: But as we're looking through this, so our employer mandate requirements, again, hopefully you're on… if you're on here today, you kind of understand your requirements to offer coverage.
00:50:30.470 - 00:50:32.609
Kelly Eckman: As an employer.
00:50:32.940 - 00:50:46.680
Kelly Eckman: our measurement methods, again, hopefully you know, sometimes we'll get questions from employers, and they don't know if they use the monthly or the look-back. That is obviously an issue as well. You need to make sure that you know
00:50:46.710 - 00:51:02.380
Kelly Eckman: what measurement method you're using, because if you don't, then how can you apply it properly? You want to make sure that it's documented, and that you are staying on top of that to make sure that you're making the appropriate offers of coverage when you need to.
00:51:03.970 - 00:51:15.359
Kelly Eckman: IRS reporting compliance. So again, I think lots on this call have just recently gone through another year of 1095-C reporting, and so the
00:51:15.360 - 00:51:28.489
Kelly Eckman: You know, the more you can do to make sure that the information in, let's say, your vendor software program is correct, and you're making offers of coverage when you need to, hopefully the easier that it makes it for reporting.
00:51:28.540 - 00:51:45.239
Kelly Eckman: And then also, hopefully, minimizing, you know, the problems where someone isn't offered coverage and they should have been, and potentially you could be subject to penalties if you didn't offer coverage to 95% of your employees.
00:51:45.310 - 00:51:54.959
Kelly Eckman: So making sure that you're appropriately identifying employees and offering coverage is so important, and that's why we kind of walked through so many of these steps today.
00:51:55.340 - 00:52:04.540
Kelly Eckman: Record keeping. So, I think sometimes we don't think about this, but making sure that you do have good records around, again, what kind of measurement period
00:52:04.720 - 00:52:11.060
Kelly Eckman: Are you using? Making sure that if you need to look up how many hours somebody worked to either
00:52:11.090 - 00:52:20.849
Kelly Eckman: prove, hey, we didn't have to offer them coverage because they were part-time. Or, we did offer them coverage, and here's our documentation where we offered it, and they declined.
00:52:20.850 - 00:52:34.669
Kelly Eckman: That kind of thing. Anything you can do as an employer, so that if you have to prove to someone or to, you know, a governing body that you made the offer of coverage, it's really important to make sure that you have that documentation handled.
00:52:35.090 - 00:52:50.770
Kelly Eckman: Plan eligibility language, this comes up a lot in our world, but making sure that, again, eligibility criteria is documented. You want to make sure that, obviously, your eligibility terms in your plan documents, certificates.
00:52:51.030 - 00:53:02.059
Kelly Eckman: You know, if you put something in a handbook, that it all aligns with these ACA requirements. So you want to make sure it all matches, and that you are offering coverage to those employees who need it.
00:53:02.170 - 00:53:09.090
Kelly Eckman: Again, making sure that you're putting… again, we use… we use the monthly, we use the look-back, we use a 12-month look-back.
00:53:09.320 - 00:53:19.350
Kelly Eckman: And our stability period is 12 months, and we run a 60-day, administrative period. You know, whatever you're doing, making sure that that is clearly documented.
00:53:19.660 - 00:53:21.090
Kelly Eckman: and included.
00:53:21.430 - 00:53:26.139
Kelly Eckman: And then, again, make sure that when you're describing eligibility requirements.
00:53:26.680 - 00:53:32.320
Kelly Eckman: For employees, that it is clear and they understand whether or not they're going to be eligible.
00:53:34.090 - 00:53:46.960
Kelly Eckman: Again, we kind of already hit on this documentation. I mean, I think our team probably can't say it enough. Document, document, document. We want to make sure that, you know, things are documented and that you are following your procedures.
00:53:48.400 - 00:53:53.129
Kelly Eckman: And the last one here, resources. Again, this is just a couple screenshots of…
00:53:53.160 - 00:54:11.410
Kelly Eckman: some of our really helpful ACA reporting resources. Again, I mentioned we use these ourselves. There's one called Measurement Methods. It's basically what we just walked through now. It's… if you're someone that, you know, you like to read and kind of learn that way instead of just listening to somebody talk through it.
00:54:11.410 - 00:54:21.839
Kelly Eckman: This is the publication for you. It's got a lot of the information we talked through, those graphs about initial and standard measurement periods, the change in status rules.
00:54:22.120 - 00:54:32.459
Kelly Eckman: and that awesome chart that Jill walked us through. Those are all in this publication, so definitely ask your consultant or advisor for a copy of that if you'd like to look at it.
00:54:32.460 - 00:54:42.860
Kelly Eckman: Another one here is the Employer Mandate Full-Time Employees publication. So again, if you're just kind of starting with the basics of identifying those full-time employees.
00:54:42.990 - 00:55:02.200
Kelly Eckman: those different classifications that Jill walked us through earlier, trying to understand those seasonal employees. Again, seasonal and interns are two topics that we hear a lot about, and employers kind of get confused on identifying those groups of employees. So just making sure that any
00:55:02.200 - 00:55:16.259
Kelly Eckman: you understand how those employees should be classified and grouped, it's really important. So we have tons of resources. Like I said, we use them ourselves, so I definitely recommend requesting those if these are some topics that you
00:55:16.640 - 00:55:26.529
Kelly Eckman: One to hear about again. And like Jill said, if you're hearing some of this for maybe the first time, you might want to go back and look through the slides again, or listen again, because it does take…
00:55:26.720 - 00:55:44.849
Kelly Eckman: a few tries sometimes to understand these nuances. I mean, again, we're 11 years from when we first started having to do this, and yet there's still lots of confusion. So definitely, you know, revisiting some of these resources, I think, is really important.
00:55:46.580 - 00:56:04.160
Kelly Eckman: And with that, I think we're at the end, and I know our team was answering questions in the Q&A earlier. If you think of a question later on that didn't get answered, again, feel free to reach out to your advisor or consultant, and they can get that to us, and we can help you out.
00:56:04.160 - 00:56:10.600
Jill Brooking: I wanted to thank the team. I wanted to thank the team. They were answering the questions fast and furious.
00:56:10.600 - 00:56:11.150
Kelly Eckman: Nice.
00:56:11.150 - 00:56:18.930
Jill Brooking: Molly, since you were in the last three and a half minutes, is there any topic you wanted to call out on a question?
00:56:22.120 - 00:56:40.349
Mollie Sledd: Yes, so actually we have an open… sorry, I'm Molly, hi everyone. We have an open question in the Q&A asking an elaboration on FMLA, protected versus non-protected leaves, and how that factors into this discussion.
00:56:41.960 - 00:56:57.709
Jill Brooking: Good question. So, there are special rules on that. So, when we were talking about the 13 weeks, like a rehire, we're not talking about protected leave, and that could be, state or,
00:56:57.870 - 00:57:02.399
Jill Brooking: federal. Remember that Federal, in a lot of states.
00:57:02.610 - 00:57:13.910
Jill Brooking: You have to… they still remain eligible for coverage, so we're not going to count that against them and say there's zero hours, and now you don't qualify for benefits.
00:57:14.190 - 00:57:20.680
Jill Brooking: And there are definitely different rules for leaves on educational plans, so it's…
00:57:20.720 - 00:57:34.699
Jill Brooking: But generally speaking, if we're talking protected, we're not going to count those, as zero hours. There's a different way to average their hours if they're in a measurement, period.
00:57:34.780 - 00:57:40.449
Jill Brooking: And don't count that against them on the rehire rule. Does that match what you were thinking, Molly?
00:57:41.150 - 00:57:50.160
Mollie Sledd: Yes, absolutely. You cannot… you cannot count FMLA, time taken for FMLA, as zero hours of service. You would… you would kind of…
00:57:50.400 - 00:58:01.600
Mollie Sledd: average the rest of the time period without that, without considering that. There are actually a couple of ways to go about it, but yeah, but the bottom line is, that does not count against them.
00:58:01.870 - 00:58:02.550
Jill Brooking: Yo.
00:58:04.110 - 00:58:04.880
Jill Brooking: Okay.
00:58:05.320 - 00:58:06.499
Jill Brooking: I think we're good now.
00:58:07.110 - 00:58:18.550
Kelly Eckman: Alright, yeah, thank you. No, that's always… that is something that comes up quite a bit, so I'm glad we were able to address that, and it looks like there were a lot of really good questions asked in the Q&A, so that's awesome.
00:58:19.500 - 00:58:22.830
Kelly Eckman: Alright, well, we will hand this back
00:58:23.000 - 00:58:28.950
Kelly Eckman: to Amber to give us a couple, final thoughts and take us away.
00:58:29.620 - 00:58:35.419
Amber Posthauer: All right. Well, thank you, Jill and Kelly, for sharing your valuable time and expertise with us today.
00:58:35.650 - 00:58:50.709
Amber Posthauer: To reiterate, today's presentation was recorded. We'll be sharing the recording in the follow-up email and on the NFP website. If there are any portions of this call that you missed, by Monday, you'll receive an email with a link to the full recording. The PowerPoint slides used during this presentation will be shared in the same email.
00:58:51.030 - 00:59:08.220
Amber Posthauer: At the end of this call, a survey will populate in a new window. Please take a brief moment to complete the survey, as it lets us know what topics are important to our listeners, and helps make our education program as current and relevant as possible. That concludes our webinar for today. Thank you, everyone, for joining us, and have a great day!
The ACA’s employer mandate has been around for over a decade, yet it can still be confusing to employers. The employer mandate provides specific ways to determine full-time employee status. The rules can be confusing depending on how the employer chooses to measure employees. Join our Benefits Compliance team for a refresher on monthly versus look-back measurement methods, identifying full-time employees, and navigating tricky employee situations.
Agenda
- Employer Mandate Basics
- Initial and Standard Measurement Periods
- Change in Status Rules
- Key Takeaways and Resources
Key Takeaways: Employer Considerations
What are the key takeaways for employers?
ACA Employer Mandate Requirements
- Applicable large employers must offer affordable minimum value coverage to full-time employees
- Risk of tax penalty for non-compliance
Understanding Measurement Methods
- Determine employee eligibility for coverage by using monthly or look-back measurement method
IRS Reporting Compliance
- Employers must report compliance with the employer mandate (1095-C; 1094-C)
- Identify employees treated as full-time employees and those offered coverage
Recordkeeping for Measurement Periods
- Maintain detailed records on the use of measurement periods, hours worked, offers of coverage, enrollments, and declines
Plan Eligibility Information
- Must include details about plan eligibility
- Align eligibility terms with ACA requirements to avoid penalties
- Describe measurement and stability periods in plan documents and summary plan descriptions
- Include eligibility requirements in offer letters or enrollment information
Documentation
- Include employer measurement method in Wrap
- Offers must be made at least once per 12 months (don’t roll over elections more than 12 months)
- Written declines of coverage are best
NFP Benefits Compliance Resources
For further information on the topics discussed during the presentation, please ask your broker or consultant for a copy of the NFP publications ACA: Employer Mandate Measurement Methods and ACA: Employer Mandate Full-Time Employees.