Initial Measurement Period Start Date
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For new hires, when does the initial measurement period start, on date of hire, or 1st day the following month?
For new hires, when does the initial measurement period start, on date of hire, or 1st day the following month?
Rhonda
Question: If an employee in 12 months works only 1 month at 130 hours but none of the other months, do we have to offer insurance.
ObamaCareFacts.com
No, as a rule of thumb an employer can calculate full-time as an average over a measuring period. An employer would typically choose a look-back of more than 1 month to avoid having to offer insurance in cases like that.
https://www.shrm.org/resourcesandtools/tools-and-samples/how-to-guides/pages/how-to-use-the-look-back-measurement-method-to-determine-full-time-status-under-the-affordable-care-act.aspx
Nancy
I was hired as full time several years ago and had company insurance (over 50 employees. I elected to drop to 20 hours Spring of last year and have been paying on the company plan through cobra. My cobra option expires before this year is out. If I increase my hours to 30 how long before my cobra expires must I do that to avoid a lapse in coverage (because cobra expired before they had to start providing coverage)? Since pay periods are biweekly would it be after one full two week pay period, the start date of the next pay period or some other date?
ObamaCareFacts.com
I am not sure of the answer. I would ask the employer on this one. It could be that upping your hours and losing COBRA is enough to qualify you, or you upping hours could just be subject to a measuring period and thus cause a gap between COBRA and qualifying for your employer health plan again. I tried to look for a definite answer, but couldn’t find one.
Tonia Watson
If I am currently on my employer’s health insurance as a fulltime employee and they are changing my status to less than 30 hours per week, how long do I get to keep my health insurance?
ObamaCareFacts.com
It depends on how long you have had it, but in general it works like this: Once you are properly a full time employee with health benefits (once the new hire period is over) you get grandfathered in each year until the end of the year as long as you keep your job. So the answer should be “until the end of the year.”
Karen Girard
I was diagnosed with breast cancer in Feb 2018, I have met my deductibles and out of pocket cost for the year under my current plan. I work for the NPS is it required to pick up the employer health insurance coverage as I am seasonal. I am in the middle of chemo, and I will have to find insurance again in 90 days time before surgery and radiation. Both out of pocket costs are upwards of $5,000 which is not affordable to me since I am seasonal and do not bring in that kind of money during the season to afford two out of pocket costs that will total $10,000 or more. Can I keep my current Obama Care plan, who determines “unaffordable” since I am unemployed in non working months. If I decline the NPS plan, what is the penalty and when will it come? Please Help me find a solution.
ObamaCareFacts.com
If you have to find insurance because you don’t have access to insurance via work, then very likely the marketplace is the solution. Affordability is determined by annual income, and eligibility is determined partly by whether or not you have coverage through work for a given month. You have a complex situation, you should call the marketplace and discuss this all with them directly to make sure you are getting it all right 🙂
Rachel
Say you have a full-time employee who has the company offered benefits after their 90 day introductory period and then after the 1 year measurement period you find that they are short on their hours and will no longer be considered full-time. How long after they are switched back to part-time status and are working do you have before they would need to be measured again for full-time status and insurance eligibility?
ObamaCareFacts.com
The measurement periods are a little complicated. Generally speaking, once you are locked into being full time in terms of receiving health benefits you can’t become ineligible until the end of the calendar year. Then for the next coverage year measurement periods are considered again.
I’m not sure I have the knowledge base to sum up every possible scenario. It is the sort of thing that you would want to consult a professional or the official documents on, clearly not the sort of thing one wants to get wrong. There are a lot of rules and stipulations.
Don
I started working for a company that has a large number of employees and from my start date I have been working more than 30 hrs per week.
My employer is denying me coverage and telling me that I have to wait a year before I am eligible.
Is this true?
BRUCE CUPP
I HAVE TWO EMPLOYEES, WHO HAVE HEALTH CARE PLANS PROVIDED
TO THEM FROM OTHER SOURCES. ONE WILL BE COVERED BY THE PARENTS MEDICAL INSURANCE FOR 3 MORE YEARS AND ANOTHER IS RETIRED AND RECEIVING HEALTH CARE BENEFITS AS PART OF RETIREMENT BENEFITS. BOTH ARE CURRENTLY LIMITED TO LESS THAN 30 HOURS WEEKLY-AS A RESULT OF OBAMACARE REQUIREMENTS. IS IT POSSIBLE FOR THEM TO SIGN A WAIVER, INDICATING THEY WILL NOT NEED HEALTH CARE BENEFITS, THEREBY ALLOWING THEM TO WORK OVER 30 HOURS WEEKLY.
ObamaCareFacts.com
Since you only have two employees the mandate doesn’t affect you. Its only for businesses with 50 or more FTE (Full-time equivalents).
Small businesses get the option of offering health insurance, if they can qualify for tax credits, if not, no problem.
Kathryn
I have worked for a company for 17 years. I serve tables, the hours change, however I have received partial health benefits for 13 years! Now, they want to drop me because they say I don’t average 30 hours a week. Is this legal?
ObamaCareFacts.com
Dropping you from coverage because you don’t work 130 hours in a month or an average of 30 a week over the course of the standard measurement period is legal.
When there is a debate with an employer it helps to have them explain their logic. This stuff can get complex and there could easily be a case where confusion has crept in on either side.
Mary L.
Clear info and thanks for the referrals to other sources.
By the way, you have an error here, I think:
“Remember employee’s can’t have….”
I don’t think “employees” should be possessive.
ObamaCareFacts.com
Good catch. Thank you!
Jim Fawcett
I work at a livestock market in Vienna Mo, called south Central regional stockyards for several years about 6 years ago they asked me to sign a paper stating I don’t want their health insurance but I was an independent contractor receiving an 1099 at the end of the year. A year or so went by and they put me on their pay roll, still have no health coverage. What can I do?
ObamaCareFacts.com
The simplest thing to do is probably to check with them. Under the current law they have to provide coverage if you are full-time, but Congress is busy changing that law right now, so that sort of changes the advice I might give. My advice is always to check with the employer first.
Glenda Hallberg
A full-time employee returned from FMLA and is now only PRN Status. She is looking at different coverage since she is no longer eligible for the insurance.
Do we need to provide her Cobra? Do we continue to provide insurance even if she is not meeting the elgibility of 30 hours.
Change in status due to health reasons.
Rose Cecil
Keep up the excellent work and bringing in the crowd!
Carl
I have an employee that was full time from 10/24/12 to 1/3/17 during which he declined coverage. He has moved to part time effective 1/4/17 as a contracted employee. He has no set schedule, and may have weeks with 0 hours worked. Must I offer him coverage due to measurement and stability periods?
Thank you.
Karly
My employer is dropping my insurance after only 1 month of being insured due to less than 30 hour per week average. I started October 19th and the average was taken from this date through January 17th. I work at a school and it was not open due to winter break (10 days) and then weather closures (5 days). Since I was unable to work due to company policies and closures, it is legal for them to drop my insurance? At this time, I continue to be a full-time employee and if averages are taken for the rest of January on through the end of the school-year, I will certainly have an average of 30 or more hours.
Karly Eaton
I should also mention that my insurance did not commence until 12/15/16
ObamaCareFacts.com
Well, they should be using measurement periods that last a long enough time to account for something like winter break.
Seems super fishy to me… but certainly some people do slip through the cracks and there is always strange loopholes.
So, seems fishy, but I don’t have an exact answer.
Marie Kaiser
I am a P/T employee with They have used a period from 11/8/2015 to 11/7/16 to determine my eligibility for insurance for 2017. I was eligible for 2016. They concur that I am not eligible for 2017 since my hours were less than 30 hrs per week. They are including the time period i was off due to an approved workers compensation injury. a period of app. 10 weeks 7/21/16 to 10/3/16. They are self insured and did pay me for that period of time based on a % amount on previous years wages. I have a rough estimate of my hours for period they used.of 1319 hours. I have tried to find a provision in the ACA to address time lost due to a W/C injury but was not successful. I have been told by the Commission I am not eligible due to federal regulations under the ACA but could not supply a manual section to refer to. I would appreciate any insight into this. I have left messages with the Dept of Labor with no response to date. thank you for any help you can provide.
Marie Kaiser
Michele S
I work an average of 19 hours per week. I have asked my employer (with greater than 50 FTE employees) to consider increasing my hours, but they won’t because they say they would have to offer health care benefits. I thought I could work up to 30 hours, not more. Please direct me to where 20 – 29 hour/week employees have to be offered partial coverage.
Pamela Grams
I live in the state of Michigan. My employer is stating that because I have already worked more than 1000 hours in the calendar, they will have to lay me off based on Obama Care laws. I have read the 30 hours a week law but is there a law for 1000 hours in a calendar year? Thank-you for any help given
Morgan
If the employee works more than 30 hours a week or 130 in a month, for more than 120 days in a year, they are full-time. Then how can the initial measurement period be longer than 120 days? Also, what are employees supposed to do for health insurance / healthcare during this (up to 15 month) period?
J'Nette Bonner
Morgan
Did you ever get a “Fact” reply to your question:
“If the employee works more than 30 hours a week or 130 in a month, for more than 120 days in a year, they are full-time. Then how can the initial measurement period be longer than 120 days? Also, what are employees supposed to do for health insurance / healthcare during this (up to 15 month) period?” My company elected an 11 month initial measurement period for new hires. I too am confused about the 120 days. Why give an employer the option to elect 3 or 12 month initial measurement periods if the employer only has the 120 days
ObamaCareFacts.com
I updated the page because, as anyone who has had to deal with this knows, it is a bit confusing.
It works like this: If you are hired full-time at a large employer, then your coverage starts within 90 days and there is no 3 – 12 month period.
If you are hired part-time, or if you work for an employer who switches over to offering coverage, or if you are full-time and hours are reduced during the year, then this is where the whole 3 – 12 months kicks in.
Essentially standard measurements are 12 months, but a part-time new hire gets an initial 3 and then goes into the standard. Meanwhile, the look-back for switching into offering coverage is 3 – 12.
Because this is all fairly complex, it is good to just open up a dialogue with your employer. If you feel like they are getting it wrong, then you probably would do well to take a close look at the graphic and research up on all of this.
This page is meant as a general place to get the basics, but we can’t offer professional tax, legal, medical advice (as we are only a free informational site).
Hope that helps clarify.
th
This link above is broken
Here is some more information on using payroll period start dates for look-back periods and initial measuring periods.
ObamaCareFacts.com
Here is the link: http://www.m3ins.com/sites/default/files/ACA_-_Payroll_period_measurement_methods.pdf
Ashley Hesser
I own a small business that has employed more than 50 employees for the past two calendar years. However, we have had a less profitable year leading us to restructure and cut down our labor cost. As of this week, we have less than 50 full time employees. Given that we are inside of the 3 month measurement period, I assume that we are no longer subject to the Affordable Health Employer Mandate. Of course, we want to do the right thing and haven’t found any professional that is confident in advising on this matter to reinforce this assessment. Please point me in the right direction for assurance!
ObamaCareFacts.com
You are right to think that your having to offer coverage is based on measurement periods and that since you won’t average 50 or more FTE in this measurement period you shouldn’t have to offer coverage. It also makes sense as to why no one wants to be that person who tells you to go ahead and drop coverage on a specific date. We wouldn’t confidently make this suggestion either as the fine for getting wrong is pretty intense. One thing to note is that your employees who do have coverage through you will be in the best place if their new plan can start on January 1st. That will give them the full-year to pay into their cost sharing on private plans. So as a safe-harbor you could offer coverage until the end of December and just take advantage of the tax breaks until then. Just a thought.
We will look into an exact answer and see what we can come up with, if anyone has a clear and definitive answer please post it in the meantime.
Chris Robison
Hi Ashley – I just ran across this and it may be too late but thought I would reply just in case. Measurement Periods have no correlation to whether you are an employer that is mandated to offer insurance. You should use an ALE calculation which is based on your prior years number of employees, not your current.
From the IRS:
Two provisions of the Affordable Care Act apply only to applicable large employers (ALEs):
The employer shared responsibility provisions; and
The employer information reporting provisions for offers of minimum essential coverage
Whether an employer is an ALE is determined each calendar year, and generally depends on the average size of an employer’s workforce during the prior year. If an employer has fewer than 50 full-time employees, including full-time equivalent employees, on average during the prior year, the employer is not an ALE for the current calendar year. Therefore, the employer is not subject to the employer shared responsibility provisions or the employer information reporting provisions for the current year. Employers who are not ALEs may be eligible for the Small Business Health Care Tax Credit.
If an employer has at least 50 full-time employees, including full-time equivalent employees, on average during the prior year, the employer is an ALE for the current calendar year, and is therefore subject to the employer shared responsibility provisions and the employer information reporting provisions.
To determine its workforce size for a year an employer adds its total number of full-time employees for each month of the prior calendar year to the total number of full-time equivalent employees for each calendar month of the prior calendar year and divides that total number by 12.”
Hope this helps…