If an employee works an average of 30-35 hours per week but is not considered “full-time” by his employer, is that employer required to offer health insurance under the ACA?


Answer

If an employee works over 30 hours a week on average, they are considered full-time by law. If the business has over 50 full-time equivalent employees they must offer coverage or pay a fee. If they are smaller then the employee doesn't have to be offered coverage and the employee can use the Marketplace to get cost assistance.

Learn more about the employer mandate.

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Coramey Burns on

I am a employee at a elementary school.
I work 6.50 a day,
180 days a year. their are 5 of us girls,, school will not give health insurance..
is there any hope for us..
thank you..
M.

ObamaCareFacts.com on

You should be able to use the Marketplace or Medicaid, it depends on the state for Medicaid. Anyone who is unsure should always call HealthCare.Gov.

Lisa Staudinger on

What really does “30 hours a week is considered full time for insurance purposes” mean? What are the specific obligations of an employer toward those who work 30 – 40 hours per week, aside from offering coverage for the employee only that costs less than 9.5% of gross income, and offering coverage of any cost for the employee’s child(ren)?

Specifically, is the employer required to offer the 31-hour-per-week employee the same coverage at the same rate as that offered to a 40-hour-per-week employee? My employer is a large ALE and charges employees who work less than 40 hours per week twice as much for healthcare coverage premiums as it charges 40-hour-per-week employees. Does that seem right to you?

Thank you so much for the relentless work you do to clarify these issues!

erin.georgen@gmail.com Erin on

Whether it seems right to us at ObamacareFacts.com isn’t really relevant. There are flaws in the Affordable Care Act (AKA Obamacare) and I’m not sure anyone is denying that. Discussing those issues in an open format helps to understand better where the ACA was successful and where is hasn’t been. As for the answer to your question though, the more detailed information regarding the Employer Mandate is linked into the answer above. Yes, generally speaking “30 hours a week is considered full-time” under the Affordable Care Act, but more specifically, “Employees who work at least 30 hours per week or whose service hours equal at least 130 hours a month for more than 120 days in a year are considered full-time.” Yes, that does mean that large employers are required to offer coverage to 95% of their full-time employees and their dependents. Only the coverage for the employee is required to be “affordable” though and employees are not required to take the insurance offered them and/or their dependents. Low wage employees may qualify for Medicaid (if the state chose to expand) or may not qualify for an exemption from the Individual Mandate (requirement to have insurance), they may qualify for CHIP for their children, they may choose a private non-marketplace plan for minimal essential coverage, or they may choose to be covered under insurance being offered by their spouse’s employer. If employees choose not to be covered offered the employer has still met their obligation to offer it. Hope this helps you understand your obligations even if it might not answer your question about whether it is fair. Fairness is a pretty subjective assessment, ObamacareFacts.com tries to focus on relaying facts and information.

Kyle on

I was hired and told I was full-time. I work 38-40 hours per week. I found out they have me in the system as part time. I have not been accruing personal time at a full time rate, nor have I been able to receive full-time benefits. I have worked there for 6 months and have worked over 30 hours every week. Is this legal? I live in Missouri and the company I work for employs more than 5000 people full time.

ObamaCareFacts.com on

You should double check with your employer, due to the way measurement periods work and how exemptions work for small employers. Generally if it is a large company and you work over 30 hours for more than 90 days you should be getting coverage as a new hire. But the specifics are too complex to give a definitive answer over a comment. Thus, best bet is to start by talking to your employer before jumping to conclusions.

John on

I work 38-40 hours per week and have done so for the past 6 months. I was told when I was hired that I was full-time but it turns out they have me in the system as a part timer. I have spoken with my employer about this and they have told me that their plan is to simply do nothing until corporate notices. The company has over 5000 full-time employees. Is what they are doing legal?

erin.georgen@gmail.com Erin on

Short answer, no, it isn’t legal.

Debbe on

My husband works at a resort in our town. They employ 1,500-2,000 people. He was told that he must work 40 hours a week to get insurance?
How can they do this?

ObamaCareFacts.com on

If he is a seasonal worker, then there are special rules (as he isn’t projected to be 40 hours a week over the course of a year).

However, even seasonal workers aren’t fully exempt, they just are subject to special rules.

Essentially this can be summarized as (see next link for more info): “Since seasonal employees only work up to six months during the year, they will generally not average 30 hours per week over 12 months because they will have very few or even zero hours for many of those months. Employers that adopt this special “measurement period,” will not have to offer health care coverage to many, if any, of their seasonal employees because these employees will not be considered to be “full-time” employees measured over the longer “measurement period.””

My guess is that is the loophole (its essentially a loophole) the employer is using. Remember though, if you don’t get employer health benefits, then you DO qualify for the marketplace. If you quality for cost assistance, the marketplace is generally a better value than employer coverage. So, likely this works out to a better value for your family when all is said and done.

If you want confirmation of the exact situation, you could always ask the employer for clarification. I’m sure someone there understands their specific policy.

See special rules that apply to employees: https://www.shrm.org/resourcesandtools/hr-topics/benefits/pages/seasonal-workers-health-coverage.aspx

See the IRS (on counting seasonal workers for purposes of employers having to offer coverage in general): https://www.irs.gov/affordable-care-act/employers/aca-and-employers-how-seasonal-workers-affect-your-ale-status AND https://www.irs.gov/affordable-care-act/employers/questions-and-answers-on-employer-shared-responsibility-provisions-under-the-affordable-care-act